NO PERMIT NUMBER „Z a 3Sit
Let No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO ``
Sanitary No.7T//�,,` OF
r �( File No.
Date •7 'y/ 196 '�/
Application is hereby made for a permit to
a story, Type
to be occupied only as '
in accordance with-Plot Plan, Plans old Specification filed herewith,
i
Estimated Value of Improvements $
FEE$ Plan Check $
Owner Address
Contr. Address
Phone �'s ` ,/ State Lican J
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEE$
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date 196 GAS FEE $
PLUMBING FEE $
Contr. 'Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 1% FEES
Contr. Address
Phone State
License
�I Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State of California
RECORD OF INSPECTION APPROVALS
BUILDING
DATE INSPECTOR MISC.
PAD FINAL
FOUNDATION
UNDERFLOOR
FRAME
LATH & PLASTER
GRADING FINAL
FINAL BLDG.
ELECTRICAL
DATE INSPECTOR MISC.
UNDERGROUND ROUGH
ROUGH WIRING
FINISHED WIRING
FIXTURES
MOTORS
FINAL
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR MISC.
BACK FLOW REQ.
SANITARY NO. 1
UNDERGROUND ROUGH 7-7
PARTIAL ROUGH
ROUGH COMPLETE
MAIN DRAIN- 647-71 -'O,
FINAL PLBG.
FINAL GAS
FINAL APPLIANCE
DATE INSPECTOR MISC.
MISC
MISC q
MISC
Bldg. Dept.
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
��. Sewer Connection Sanitary Permit No. -----.rf..���-h�.........
�( Plumbing Final Plumbing Permit No. ...5 /1...j.......
LotNo. --------------------------------
Owner
------
Owner or Tenant ... ...---"�`.c-'.:.:....---4_<-s.r:2.-c:+.a�/
At Glia P - ----
Tract
-Tract
Date Connected .......
: 7-- � -------------------------------------------------------------- 19...
Date Final .......... ....�..` 21 \ '----- 19.----------
_.... -
-
Ill 12/66-1M PLUMBING INSPECTOR
�n�� Sc7 l=JI �Ui= .CG�C CC wf.�L. - 'X'. '•/�
LOT NO.`
STREET'
CITY OF CUPERTINO..
S 'I8?APPLICATIONFORJELECTRICAIt`PERM IT
,. �r ;�. 1 "•• ` - .'Permit No
Data' 1J ',197 fid' r•.
FeeST
Application is hereby made to the City of Cupertino for a' pernnittto-install electrical
Y, .wiring and/orTfixtures as- lisied on � and agrees Tooinstall'iaid
wiring and/or,fiztures in accordance with �pr`ovisions'ofthe Electrical Code.of the'-'. J+
City,of Cupertino; ap xand all other laws cable thereto ;
Premises •O�iS i C/E/!.«.' Perform PK-V I C'�C /� •�G•1 e., �t..
Owne�t• ` 'f 77�L'"�. �` +F/7 yl Address�Q3�a +rf L1L'r'CC��
ri
By Address
Contractor;Apenti i fy.},' .
:'Phone .. '.d
s"' �• 'ZI
Stat,L ii" e>f:kD L)CI\Appro 40 h•. +' `,
e1 i•{ �... El
e- ical, speddi
I
AGREEI`I_WILL NOT VIOLATE ANY''OF THE RKM 'S
l _ COMPENSATION LAWS"OF TME STATE0F ` NIA.
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