NO PERMIT NUMBER (2) t. ,.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File N�Qv
Sanitary No.T
Dote 196
Application is hereby made or a permit to
a story, Type
to be occupied only as
in a r nce with Plot Plan, Plans and Specification filed herewith,
Estimated Vol of Improvements $
FEES ,[�' �f' �j,,, Plan Check $
0
Owner _L l_/ //LfA Address
Contr. ' Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Data 196 FEES
Cont,. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Dote 196 jr- GAS FEE $
PLUMBING FEE $ --
Contr. At Addres/��f7 a4dzm'41.1
,4—
Phone jZ State License' 4 AKA? 7Ie27 co-or
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEES
Contr. Address
Phone ,State License
Approved
Applicants agree not to violate any of the
Workman's Compensation Latus of the
State of California .
RECORD OF INSPECTION APPROVALS
FOUNDATION BUILDING
Date Inspector
UNDERFLOOR
Date Inspector
FRAME
Date Inspector
LATH & PLASTER
Date Inspector
FINAL
Date Ins ae c tar
ELECTRICAL
,OUTLETS
SERVICE SIZE
SWITCHES UNDERGROUND
Data Inspector
RECEPTACLES ROUGH WIRING
Date Inspector
FIXTURES FINISH WIRING
Data Inspector
H.P. CHARGE FIXTURES
Date Inspector
PERMIT FEE Motors
Date Inspector
TOTAL FEES FINAL
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE I MATERIAL
STORM DRAIN SIZE TERIAL
WATER SYSTEM SIZE IA'TERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Date Inspector
MAIN DRAIN FEE WIC ROUGH COMPLETE
70 5�XEZFv— OK Dotdo Ins r
STORM DRAIN FEE .ea- MAIN DRAIN
Date Insp ctor
WATER SYSTEM FEE GAS PIPING
Date Inspector
GAS PIPING FEE FINAL
Date Inspector
PERMIT FEE � MISC
,[ Date Inspector
TOTAL FEE T 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
Data Inspector
Bldg. Dept
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
ewer Connection Sanitary Permit No. 4.4..-7-4...........
Fl Plumbing Final Plumbing Permit No. /.
LotNo. ......_.....----..........
Owneror Tenant ..... .. ------- ------------------------------ . ......... ..... -- -------------------
At ----------- ....... ............... ..
Tract ....------------------------ ---------------------------------------------- ........... ....................................
Connected ...... 14
Date Conne ,
------------------------ 7--------------------- ---------------------------------------- 19CIr
Date Final ------------------------------------ t��— — f I
--- ----------------- -- --- ...... -- - -----------------
... .... ...... - - - .... ......
Ill 7/63-IM 'P MBING INS OR
' NO. STN F.F.'I'
APPLICATION FOR PLUMBING PERMIT
z a CITY OF CUPE:RTINO
r ory Sanitary No.
3 U Dare— ! 7" 196—c� Permit No.
i o Pee $
4 w Application is hereby made to the City of Cupertino for a permit to install plumbing
0 1- pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
i and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other laws applicable thereto.
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' PLUMBING INSPECTOR
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