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