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NO PERMIT NUMBER Lot No. No. Street APPLICATION FOR BUILDING PERMIT CITY OF CUPERTINO File No.lDU, d 03 Sanitary No. Dote 196 Appljcation is hereby made for a per&W tom,. /lam st ry, Type to be oon('ly as I SfrrP 2 nn RA, plan, Plans and,4pecification filed herewith„ C �s d�p`y0 p( I�araonents $ FEE$ - uU�t//ttK ll�''�NNv\U!1 Plan Check $ Owner _ VN..0-P�r� (�.C.C.[�at.�Jh--! Address Contr. _�. L('' " Address o�-4 Phone �srx � �-5 i/ (1 State License a d Approved NIILLIPJA D. MENEVICH APPLICATION FOR ELECTRICAL PERMIT Date 196 FEE$ Contr. Address Phone State License Approved APPLICATION FOR PLUMBING & GAS PERMIT Date 196 GAS FEE $ PLUMBING FEE $ Contr. Address It IJ Phone State License Approved APPLICATION FOR APPLIANCE PERMIT Date 196 FEES Contr. Address i 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 FINAL V Rotor 44M pector � Date Ins Dector ELECTRICAL ,OUTLETS SERVICE SIZE SWITCHES UNDERGROUND Date Inspector RECEPTACLES ROUGH WIRING Date Inspector FIXTURES FINISH WIRING H.P, CHARGE FIXTURES Date Inspector 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 ldwTERIAL WATER SYSTEM SIZE IATERIAL TOTAL FIXTURES . UNDERGROUND FIXTURE FEE PARTIAL ROUGH Date Inspector MAIN DRAIN FEE ROUGH COMPLETE Date Inspector STORM DRAIN FEE MAIN DRAIN Date Inspector WATER SYSTEM FEE GAS PIPING Date Inspector GAS PIPING FEE FINAL Date Inspector PERMIT FEE 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 Date Inspector ___