NO PERMIT NUMBER Ye3 Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Sanitary No.
a V ,9y
G File No.
Date 196 . .
- . Application is hereby made for a permit to
to be occupied only as
in accordance with plo lan, PAW and Specification filed herewith
Estimated Value of Improvements s l7 d O d
/ a
FEES. Plan Checks _
Ow r,er v. ^ 'Address
Contr. OCJGrn.J / /dPLX Address .39 .5"
Phone -7 -S State License
.WILLIAM D. c
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date.
+,�1S a0 196�� F ES
Contr
ess
Phone Q:F>Q , 1 1 k9 State License
e
. Approved a:ii9 9. Ei,= lEb�
APPLICATION FOR PLUMBING 8,-GAS PERMIT
Date 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'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
FIXTUR 10 111/
MOTORS
FINAL
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR MISC.
BACK FLOW REO.
SANITARY NO.
UNDERGROUND ROUGH
PARTIAL ROUGH
ROUGH COMPLETE
MAIN DRAIN
FINAL PLBG.
FINAL GAS
FINAL APPLIANCE
DATE INSPECTOR ' MISC.
MISC
MISC
r
MISC
No. Street Lot No. � y
APPLICATION FOR BUILDING PERMIT
p i fCupertino
-� Date Sanitary No.
196
� Permit No.
`o o Apphca[ion i e4e�+ �adA(Y' it
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3 a story,T/yyg) Building
V to be occuly®r n tt TSicwv....� L-r— >' m accordance with
o vii II ii 1—�PL:��TT & .
° Plans,Specifications and Plot-Plan fi ed herewit 1 Ck Fee
T �
Estimated Value of Improvements,$ 4&-" i Fee$
o o It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
> all other laws applicable to the construction, location, and use of buildings within the City of
mCupertino will be complied with.
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ee
Stale License
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d No. srRiurz LOT NO.
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eo ° FOR ELECTRICAL PERMIT
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OF CUPCRTINO
i 111
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a F D / 1l' — Permit No.
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< liQ�yon,
n �f�9 �� the City of Cupertino for a permit to install electrical
klyw s id arTA/�or �Citr 'a's'l i.it'e(on the reverse side hereof, and agrees to install said
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0 LL wiring and/or fis aes in accord:mcr. with the n the jilectrical Code of the
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3 City of Cupert( nd all other laws applical th
j Use of PremisesSMMld' CAA{. . Apalkift
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3 a OwnerAddress
p a By /7? �� i/S f / Addres _
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State License ��� /
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