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NO PERMIT NUMBER (8) /off a :;iiv ,d- ,�i No. Street APPLICATION FOR BUILDING PERMIT CITY OF,CUPERTINO Sanitary No. File No. Do to 196 Application is hereby made for a permit to a story, Type to be occupied only as in accordance z Plot Plan, Plans and Specification filed herewith„ Estimated Value of Improvements $ FEE$ Plan Check $ Owner �� �'/1Address �1 Contr. � �L "'���r (;Udress +��} � Phone / —i —� T State License Approved APPLICATION FOR ELECTRICAL PERMIT' Date 196 FEES Contr. Address Phone State License Approved APPLICATION FOR PLUMBING & GAS PERMIT Date 196 GAS FEE $ PLUMBING FEE $ Contr. Address Phone State License Approved APPLICATION FOR APPLIANCE PERMIT Date 196 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 DATE INSPECTOR MISC. PAD FINAL FOUNDATION UNDERFLOOR FRAME LATH 8 PLASTER GRADING FINAL FINAL BLDG. X30 7D ELECTRICAL DATE INSPECTOR MISC. UNDERGROUND ROUGH ROUGH WIRING FINISHED WIRING FIXTURES MOTORS FINAL PLUMBING, GAS & APPLIANCE DATE INSPECTOR MIS BACK FLOW REQ. SANITARY NO. _ UNDERGROUND ROUGH PARTIAL ROUGH ROUGH COMPLETE ' MAIN DRAIN FINALPLBG. FINAL AL APPLIANCE DATE INS PE'C TOR MISC: MISC MISC MISC 58 CERTIFICATE OF COMPLETION BUILDING INSPECTOR'S OFFICE CITY OF CUPERTINO �U - 7O SI21 Date .... ..'--..l_.............7........., I').. _---..... �Bu+ilding Permit No. .�-7............._. The Building Located at ._� k �D Il-�C. +.S'T <-L,`%✓,�,-. i` D. - ....- -................................................... Owned b wla. T.t r?N_ -cc]n.i4. .. ........ Has Been (�ComPAd) For Use As: .....C7.......4�:�t-l�-.�U(-.1 - ....._.................'-`----........-,;........-----..................---.-*--------- ........ ------...................................... ---......----'-----.......-`....................---"---..........I.._.............'---.........-'--'-............................_...... .:..-----....................:.................. .............---.............-4BUTTLIDING . -------..._ ---`----------...... . .------------ -- INSPECTOR