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FILE 51139Lor. No. • J� APPLICATION FOR BUILDING PERMIT r CITY OF CUPERTINO { File No.v( //j3p Sanitary No. Data, � 196 ..L� Application is hereby made for a permit to �y astory, Type— to be occupied only as p I �' - , �— _ r _ D��Q in accordance with Plot plan, Plans and Specific -0 filed herewith„ Estimated Value of Improvements $ V FEE$ Plan Check $ Owner Address Contr. Address Phone ,PS42 State License Approved &01 Date , Contr. Phone I Date APPLICATION FOR ELECTRICAL PERMIT 196 FEE$ Address State License Approved APPLICATION FOR PLUMBING & GAS PERMIT 196 GAS FEE $ — PLUMBING FEE $ Contr. Address Phone State License ., Approved APPLICATION FOR APPLIANCE PERMIT Date 196 FEES Contr. Address Phone State License Approved Applicants.agree not to violate any of the Workman'sCompensation Laws of the State of California RECORD OF INSPECTION APPROVALS FOUNDATION BUILDING ELECTRICAL Date I UNDERFLOOR UNITS STORM DRAIN SWITCHES Date Date FRAME Inspector ROUGH WIRING FIXTURES to UNDERGROUND LATH TER Date j to KD MAIN DRAIN FEE FINAL Date ROUGH COMPLETE Inspector ELECTRICAL SERVICE SIZE I ,OUTLETS UNITS STORM DRAIN SWITCHES I Date RECEPTACLES Inspector ROUGH WIRING FIXTURES UNDERGROUND H.P. CHARGE Date PERMIT FEE FINISH WIRING MAIN DRAIN FEE TOTAL FEES Date ROUGH COMPLETE Inspector ELECTRICAL Date Inspector PLUMBING & GAS MAIN DRAIN SERVICE SIZE I UNDERGROUND UNITS STORM DRAIN I SIZE I Date REGISTERS Inspector ROUGH WIRING TOTAL FIXTURES UNDERGROUND COMBUSTION VENT Date Inspector FINISH WIRING MAIN DRAIN FEE MISC Date ROUGH COMPLETE Inspector Date Inspector FIXTURES WATER SYSTEM FEE Date GAS PIPING Inspector Dote -PERMIT FEE Inspector Motors PERMIT FEE Date MISC Inspector Date Inspector FINAL Date Inspector PLUMBING & GAS MAIN DRAIN SIZE I MATERIAL UNITS STORM DRAIN I SIZE I LL4TERIAL REGISTERS WATER SYSTEM SIZE ITERIAL TOTAL FIXTURES UNDERGROUND COMBUSTION VENT FIXTURE FEE PARTIAL ROUGH MAIN DRAIN FEE MISC Date ROUGH COMPLETE Inspector STORM DRAIN FEE Date MAIN DRAIN Ins pector WATER SYSTEM FEE Date GAS PIPING Inspector GAS PIPING FEE -PERMIT FEE Date FINAL Inspector PERMIT FEE Date MISC Inspector TOTAL FEE Date MISC Inspector 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