NO PERMIT NUMBER Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
fila No.
Sanitary No.
Data 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 Value of Improvements $
FEES Plan Check $
Owner//.�A iEil.�/�Jr'l//G �yc.76'f/� Qui
Address
Contr. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEE$
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date j e/ 196
GAS FEE $
PLUMBING FEE $ 7, -5 --J
Contr. _%. Zi/. ia�_„ Address
Phone l?6--1 -71 1 `,�Q�y
State License �Iy'- J%
Approved
APPLICATION FOR APPLIANCE PERMIT
Data 1% FEE$
Contr. Address
Phone State License
Approved '
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State of California '
RECORD OF INSPECTION APPROVALS
BUILDING
FOUNDATION
DATE INSPECTOR
UNDERFLOOR
DATE INSPECTOR
FRAME
DATE INSPECTOR
LATH & PLASTER
DATE INSPECTOR
FINAL
DATE INSPECTOR
ELECTRICAL
ELECT. SERVICE
DATE INSPECTOR
UNDERGROUND
DATE INSPECTOR
ROUGH WIRING
DATE INSPECTOR
FINISH WIRING
DATE INSPECTOR
FIXTURES
DATE INSPECTOR
MOTORS
DATE INSPECTOR
FINAL
' DATE INSPECTOR
PLUMBING & GAS
UNDERGROUND
' DATE INSPECTOR. ..
PARTIAL ROUGH
DATE INSPECTOR
ROUGH COMPLETE
DATE ECTOR
MAIN DRAIN
DATE INSPECTOR
GAS PIPING
ECTOR
IN AL
TE INSPECTOR
MISC
DATE INSPECTOR
MISC
' DATE- INSPECTOR
APPLIANCE
INSPECTED
DATE INSPECTOR
MISC
DATE INSPECTOR
MISC
AINSPECTOR
DTE
MISC
DATE INSPECTOR
Bldg. Dept
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
❑ Sewer Connection Sanitary Permit No. ...✓v7-2-
..................
�Plumbing Final Plumbing Permit No. �i..........
LotNo. ...............................
Owner or Tenant,)W-.—
At
- ------------------------------------------------
Tract ....................
Date Connected ....................
--------------------------------------------------
Date Final -------------------------
--------2-7.2.7---------....----4---- ------ ---------- 19CO-7---
.........................
...........
III 7/63-IM PLUMBING INSPECTOR