NO PERMIT NUMBER (5) RECORD OF INSPECTION APPROVALS
FOUNDATION BUILDING
Date Inspector
UNDERFLOOR
Date Inspector
FRAME
Date Inspector
LATH 8 PLASTER
FINAL Data Ins pe nor
Date Insoector
ELECTRICAL
,OUTLETS 'Y
.SS SERVICE SIZE
SWITCHES
UNDERGROUND
/
RECEPTACLES ROUGH WIRING Date Inspector
F IXT RES FINISH WIRING Date Inspector
Dote Ins
H.P, HARGE FIXTURES Inspector
PERMIT FEE / Motors Date Inspector
TOTAL FEES (� J ' a %0,k9 to Inspector
FINAL
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE I I MATERIAL
STORM DRAIN SIZE I MATERIAL
WATER SYSTEM SIZE IATERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
MAIN DRAIN FEE ROUGH COMPLETE Date Inspector
STORM DRAIN FEE MAIN DRAIN Date Inspector
WATER SYSTEM FEE GAS PIPING Date Inspector
GASPI PING FEE FINAL Date Inspector
PERMIT FEE MISC Date -Tn.
Date Inspector
TOTAL FEE � MISC
Date Inspector
APPLIANCE
TYPE OF APPLIANCE UNITS FEE TYPE OF APPLIANCE UNITS FEE
CIRCULATING HEATERS REGISTERS
BLOWER FURNACES COMBUSTION VENT
SUSPENDED UNIT MISC
GAS RANGE MISC
GAS DRYER PERMIT.FEE
FLOOR FURNACE TOTAL FEE
INSPECTED
Date Inspector
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No. J 7D.2 7
Sanitary No.
Do to 196 .�.�
Appl' tion tS-heuaky,made for¢ permit t
a Y. Type
to he occupied only as
in accordance with Plot Plan, Plans and Specification filed herewith,
Estimated Value of Improvements $
FEES n Plan Check $
Owner ` Address
Contr. Address
Phone State License
Approved
PERMIT
APPLICATION FOR ELECTRICAL PE
� 6 3s-
Date i+�s`� ) 196 FEES
Contr. L� ti•C..d"�-J Address
Phone 370ry /Q 6 / State License /L/7L 7 �J V
Approved
v
APPLICATION FOR PLUMBING 8, GAS PERMIT
Dote 196 GAS FEE $
PLUMBING FEE $
Contr. Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEES
C ontr. Address
Phone State License
Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State of California