NO PERMIT NUMBER No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No./o 0, 0
Sanitary No.
Data � C � 196
Appli ion is hereby ma for a permit
s ory, ype
to be occupied only r
in accordance with Plot Plan, Plans and Specification filed herewith.,
Estimated Value of Improvements $
FEES Plan Check $
Owner Address
Contr. Address
Phone State License
Approved
• M sem_
APPLICATION FOR ELECTRICAL PERMIT
Data 196 FEE$
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT �7
Date 196 GAS FEE $
PLUMBING FEE $
Contr. Address
Phone State License
Approved
/O APP
ICATION APPLIANCE PERMIT ere
Data 196 FEES
Contr. Address
Phone _ "q- s- - a�3S6
State License
Approved �J�CA.tN2eC..r �r
Applicants agree not to violate any of the r
Workman's Compensation Laws of the
State of California
RECORD OF INSPECTION APPROVALS
FOUNDATION BUILDING
Date Inspector
UNDERFLOOR
FRAME Date Inspector
Date Inspector
LATH & PLASTER
Date Inspector
FINAL
Date Inspector
ELECTRICAL
,OUTLETS . SERVICE SIZE
SWITCHES UNDERGROUND
Dote Inspector
RECEPTACLES ROUGH WIRING
FIXTURES FINISH WIRING Date Inspector
H.P, CHARGE FIXTURES Date Inspector
Date Inspector
PERMIT FEE Motors
Date Inspector
TOTAL FEES FINAL
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
WATER SYSTEM SIZE ITERIAL
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
ate Spector
GAS PIPING FEE FINAL
Date Inspector
PERMIT FEE MISC
Date Inspector
TOTAL FEE MISC
Date Inspector
v 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 E
FLOOR FURNACE TOTAL F
INSPECTED 11�
Date Inspector
I
GAS SERVICE NOTICE OFCOPY,
I
C BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
_.........../.I �
To
You are hereby authorize o connect th GAS service for
Owner or Tenant ._._... .._ .
..
New ery c• ... .....
No. of Meters ..._._ ...._...... Reconnect
Move Service .._....................
No. of Add. Meters ........ ..... Mo Meter .... ... ...............
........... . .... ...................:............. ... ..
PLUMBING INS :C OR