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NO PERMIT NUMBER No. Street APPLICATION FOR BUILDING PERMIT CITY OF CUPERTINO File N..100- 06.r Sanitary No. Date 196 Application is hereby made for a permit to a story, Type to be occupied only as in accordance with Plot Plan, Plans and Specification filed herewith. Estimated Vale, of Improvements $ FEE$ Plan Check $ Owner Address OF Contr. - Address Phone caftzy� State License Approved c APPLICATION FOR ELECTRICAL PERMIT Date 196 r FEE$ Z 0— Contr. V Address .—/0 0,0/�(Lt�Y�` Phone ot" ' .Ssa State License /''l 7 _ Approved APPLICATION FOR PLUMBING & GAS PERMIT Data 196 GAS FEE $ PLUMBING FEE $ Contr. Address Phone State License Approved APPLICATION FOR APPLIANCE PERMIT Data 196 FEES Contr. Address Phone State License Approved Applicants agree not to violate any of the Workman's Compensation Laws ofthe State of California RECORD OF INSPECTION APPROVALS FOUNDATION BUILDING Date Inspector UNDERFLOOR Date Inspector FRAME Date Inspector LATH & PLASTER Date Inspector FINAL Date Inspector ELECTRICAL ,OUTLETS SERVICE 517_E SWITCHES UNDERGROUND Date Inspector RECEPTACLES ROUGH WIRING Date Inspector FIXTURES. FINISH WIRING UV Date Inspector .P. CHARGE , FIXTURES Date Inspector PERMIT-FEE P'Y Motors jj D f s ctor TOTAL FEES a2 FINAL ate Inspector PLUMBING & GAS MAIN DRAIN SIZE I I MATERIAL STORM DRAIN I SIZE I Lmm6TERIAL WATER SYSTEM SIZE IATERIAL TOTAL FIXTURES UNDERGROUND FIXTURE FEE PARTIAL ROUGH Date Inspector MAIN DRAIN FEE ROUGH COMPLETE Data Inspector STORM DRAIN FEE MAIN DRAIN Date Inspector WATER SYSTEM FEE GAS PIPING Date Inspector GAS PIPING FEE FINAL Date Inspector PERMIT FEE MISC Date Inspector TOTAL FEE MISC ' Data 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