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NO PERMIT NUMBER ✓AA �/ I ��/����F. �R Lot No. No. Street ,APPLICATION FOR BUILDING PERMIT CITY OF CUPERTINO Sanitary No. File No.�� Date 196 -7-- Application is hereby made for a permit to a story, Type In he occupied only as in accor nce,with plot Plan, Pians and S cification filed herewith, Estimated Value of Improvements $ FEES �7 Pt Plan Check $ Owner / � AdTA.r.a.o Address Cant, Address Phone 0 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 Data 196 FEES Contr, Address Phone State License ,i Approved Applicants agree not to biolate any of the Workman's Compensation Laws of the State of California RECORD OF I+!SPECTION APPROVALS BUILDING DATE INSPECTOR MISC. PAD FINAL, FOUNDATION UNDERFLOOR FRAME LATH & PLASTER GRADING FINAL FINAL BLDG. ELECTRICAL DATE INSPECTOR MISC. UNDERGROUND ROUGH ROUGH WIRING FINISHED WIRING FIXTURES MOTORS FINAL PLUMBING, GAS & APPLIANCE DATE INSPECTOR MISC. BACK FLOW REQ. SANITARY NO. UNDERGROUND ROUGH PARTIAL ROUGH ROUGH COMPLETE MAIN DRAIN FINAL PLBG. FINAL GAS FINAL APPLIANCE DATE INSPECTOR MISC. MISC MISC MISC I � Bldg. Dept. Office Copy CITY OF CUPERTINO SEWER-PLUMBING NOTICE F-I Sewer Connection Sanitary Permit No. _471!18-- --- --- Plumbing Final Plumbing Permit No,--, . .......... Lot No. .....-.—... Owner or Tenant 6�_,WeK a . ---------............. --- -­. ....... At w. ................ Tract Date Connected ............ ------------Q/__j...................................................... ..... DateFinal ............................A_?-—---- -------------- ---- ----- -------------------------- 1940.. ---- AP --------------------- L�MB&NC� JN�SPECCFOR LOT NO. ` O. MEEI' :AP CN FOR PLUMBING PERMIT w i ® 1 P CUPERTINO �® Sanitary No. r � R Oj 3 o U Date - Permit No. _��9 W LL Pee $ , 0 ApplC;>1t: ty isgrebPppyb Dy of Cupertino for a Permit to install plumbing o a pipes and?or fix s h hcaaddfo •t 1 se side hereof, and agrees to install said prices i and/or fixtures in accordance with the provisions of the Plumbing Code of the City of a w Cupertino, and all other laws- thereto. W 4 Use of Premises 00 3 Owner 0 / �t Air Address 2,2-f-171. .,ryC.�aO.QI O J o By. Address 3 r CONTRACTORAGENT - o Phone State License Approve PLIJM8ING INSPECTOR E & - { � § 00 0000 \� % ee ® ° ) ( ( * ~ ` tv ° ) ` ° w [ m2 \ $ �