NO PERMIT NUMBER A 3 71 � (�' Lot No.
No. IStreet
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No.,$—//-
Sanitary No.
Date 196
Applicatio ereb in efo it to
story, Type
to be occu 'ed onl as '
in accordance ith Plat n, Plans and Specification filed herewith.
,Esttma ted Value of Impro ements. $
i "
FEES ` �
. Plan Check E
Owner Address
Contr. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
Contr. Address
Phone q' State License
Approved
I1 p,p
PfIF{�iAn"PT fi I@C4 L MING & GAS PERMIT
Date 196 CH GAS FEE E
ITY F U TSN^_ PLUMBING FEE $
Conti. Address
Phone _ State License_
Approved (// _ • = e�� ���LrI
APPLICATION FOR APPLIANCE PERMIT
Data 196 FEES
Contr. Address
Phone State License
Approved'"', ,
Applicants agree not to violate any of the r
Workman's Compensation Laws of the '
State of California
RECORD OF INSPECTION .APPROVALS
.FOUNDATION BUILDING
Date Inspector
UNDERFLOOR �
Date Inspector
FRAME
Date Inspector
LATH & PLASTER
Date Inspector
FINAL
Data Insoector
ELECTRICAL
,OUTLETS
SERVICE SIZE
SWITCHES UNDERGROUND
Date Inspector
RECEPTACLES ROUGH WIRING
Dote Inspector
FIXTURES FINISH WIRING
- Date - Inspector '
H.P. CHARGE FIXTURES
Date Inspector
PERMIT FEE Motors
Date Inspector
TOTAL FEES FINAL
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE I I MATERIAL
STORM DRAIN I SIZE TERIAL
WATER SYSTEM SIZE IATERIAL
TOTAL FIXTURES . UNDERGROUND
FIXTURE FEE too PARTIAL ROUGH
Date Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Date Inspector
STORM DRAIN FEE MAIN DRAIN
' Dote Inspector
WATER SYSTEM FEE �d GAS PIPING
(N�,tspb( Data for
GAS PIPING FEE FINAL /® ��' '�
Date Inspector
PERMIT FEE r% MISC
Date Inspector
TOTAL FEE MISC
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
Data Inspector _ _