NO PERMIT NUMBER (28)P- 6z
R Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Dote 6��196-7—
/ Application is hereby made for a permit to
a
to be occupied only as
'Sanitary No.
File No.
story, Type
in accordance wi(Plot Plan, Plans and Specification filed herewith,
Estimated Value of Improvements $
FEES Pion Check $
Owner Address
Contr. Address dPd/
Phone�'SY'% .3 - 19F (trl State Licens
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date
196 FEES
Contr.
Address
Phone
State License '
. Approved
APPLICATION FOR PLUMBING 8, GAS PERMIT'
Date
196 GAS FEE $
PLUMBING FEE $
Contr.
i
Address
Phone
State License '
Approved
APPLICATION FOR APPLIANCE PERMIT
Data
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.
UNDEF
ROUGI
FINISF
FIXTU
MOTOI
FINAL
ELECTRICAL
DATE INSPECTOR MISC.
GROUND ROUGH -
I WIRING
ED WIRING
RES
S
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