NO PERMIT NUMBERa dS
T
ISt•
CITY OF CUPERTINO
;APPLICATION FOR BUILDING PERMIT a
SANITARY NO.
FILE NO.
DATE 19_
Application is hereby made for a permit to
a story, type
to be occupied only
LOT NO.
in accordance with plot plan, plans and specification filed herewith.
PHONE
STATE LICENSE
ESTIMATED VALUE OF IMPROVEMENTS $,
FEE $
PLAN CHECK $
OWNER
DDRESSPHONE
—ADDRESS—
PHONE
DATE
PHONE
STATE LICENSE
PRE-GUNITE
FRAME
BOND BEAMS
LATH
BUILDING INSPECTION RECORD
FIREWALLS
DATE
I INSPECTOR
DATE
INSPECTOR
PRE-GUNITE
FRAME
BOND BEAMS
LATH
WALLBOARDS - INT.B EXT.
FIREWALLS
MEMBRANE
LANDSCAPING
/
F.M.O. INSPECTION
FINAL BLDG.
s F.P.$
RESIDENTIAL I DATE I INSPECTOR I COMMERCIAL I DATE I INSPECTOR
UNDERGROUND ROUGH
UNDERGROUND ROUGH
ROUGH WIRING
ROUGH WIRING
FINISH WIRING
FINISH WIRING
FIXTURES
INTERIOR FIXTURES !
MOTORS
EXTERIOR FIXTURES
FINAL
MOTORS
MAIN DRAIN I ( g—
FINAL
MISCELLANEOUS INSPECTIONS
PLUMBING INSPECTION RECORD HEATING 8 A/C INSPECTION RECORD
DATE I INSPECTOR i I DATE I INSPECTOR
BACK FLOW REQUIRED
UNDERFLOOR S.M.
BACK FLOW INSTALLED
DUCTS 8 INSULATION
UNDERGROUND ROUGH
FLUES 8 COMB. AIR
PARTIAL ROUGH
CONDENSATE DRAINS
ROUGH COMPLETE
FINAL APPLIANCE
ROOF DRAIN 8 LEADERS
MAIN DRAIN I ( g—
FINAL GAS
FINAL 1`640ho81TUG_,
-20 0K cJC,A/ Rr jrt: JK' LOT NO.
NO _ V t'STREET
Oi
(, CITY OF CUPERTINO
1O I APPLICATION FOR PLUMBING PERMIT
Sanitary No.zaL_ 9V+
late 19_ Permit No.
Fee 5 y p
Application is hereby made to the City of Cupertino for a permit to install plumbing
pipes and/or fixtures listed on the reverse side hereof, and agrees to install said pipes
and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
Cupertino, and all other laws applicable thereto.
Use of Work To Be
Premises Pevfornl
Owner c /�Y i 2 l o Address
Phone r� a /, ,,/r /
By Lf Addresses Zr2, E � Cf o � 7✓ /V( Sex" /d (i4fd
on radarr,,yA ntt
Phoney — 3e � % 7 S
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State Licens7 A� Approved-
Plumbing Inspector
I AGREE I WILL NOT VIOLATE ANY OF THE WORKMEN'S /F
COMPENSATION LAWS OF THE STATE OF CALIFORNIA.
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NO.C!�'T , " : I -STREET
'A79. CITY OF CUPERTINO
U APPLICATION FOR APPLIANCE PERMIT
pn!P
IC -A - I I ,,91�j-
Permit No.
Fee $ 7
Application is hereby made to the City of Cupertino for a permit to install gas
appliances as listed on the reverse side hereof, and agrees to install said appliances in:
accordance with the provisions of the Plumbing Code of the City of Cupertino, and all,
other laws applicable thereto.
N
Work To Be
Performed �FU�pR`n'Ac� IA)5T7� I OTtnr,�
AddressSZi1J/5�1 Sun RISE D
Address bss ' ` • i 4L
SAn 70SE, CL A 9511a
Approved
Plumbing Inspector
I AGREE I WILL NOT VIOLATE ANY OF E WORKMEN'S K
COMPENSATION LAWS OF THE STATE OF CALIFORNIA.
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