NO PERMIT NUMBER No. Street
APPLI ATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No./ a L
Sanitary No.
Data 196
Application is hereby ma)e op
ermit to
a story, Type
to be occupied only as
in a ordance with Plot Plan, Plans and Specification filed herewith,
Estimated slue of Improvements $
t y
FEES PPlan Check $
Owner Address
Contr. Address
Phone ? 2 Cff State License
Approved;'
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
Conti. Address
Phone State License
An qftc�l
Approved
RIYUV LiSOWFR pf��JI�ABING & GAS PERMIT
Data 196 GAS FEE $
�' Or• �'��. PLUMBING FEE $
Phon State License
Approved ( � _
'APPLICATION FOR APPLIANCE PERMIT
Date 196 FEES
Conti. 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 '
FOUNDATION BUILDING
Date Inspector
UNDERFLOOR
Date Inspector
FRAME
Date Inspector
LATH & PLASTER
Date Inspector
FINAL
Date Ins ae c tar
ELECTRICAL
.OUTLETS
SERVICE SIZE
SWITCHES UNDERGROUND
Data Inspector
RECEPTACLES ROUGH WIRING
Date 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 I L66TERIAL
WATER SYSTEM SIZE IATERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Date Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Do to Inspector
STORM DRAIN FEE MAIN DRAIN
Date Inspector
WATER SYSTEM FEE GAS PIPING
Date Inspector
GAS PIPING FEE FINAL
D e pector
PERMIT FEE 0- MISC ( �
�O 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
Date Inspector
GAS SERVICE NOTICE OFFICE
BUILDING INSPECTOR'S OFFICE COPY
CITY OF CUPERTINO
.......................... ........ ...... 196. 4
TO
You are hereby aut"rizedto nnect t AS service for
Owner 0�armee
At ...
. ......................
... . . ...
New Service
............
No. of Meters .......... .......... Reconnect
M e Service ....................
Service
...
No. of Add. Meters .............. 0 e eter .....................
....... ............
To
NG I N"'
PLUMBING INSP TO