51140No.
Lot No.
Street l:
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Date r/ 02'!�—
196
Application is hereby made for a permit to
a
to be occupied only as
in
File No.
Sanitary No. -49"k
story, Type
cc with plot plan, Planland Specification filed herewith,
Estimated Value of Improvements $
FEES i� �� Plan Check E
Owner Address n
Cont'. Address i( PL—e, C'- -rc
Phone 6 Z State License
Approved 1'1�cj
r�
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
Contr, Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Data 196 GAS FEE E
PLUMBING FEE E
Contr. Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Data 1% FEES
Contr, Address
Phone°
Stara License
Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State of California ,
RECORD OF INSPECTION APPROVALS
BUILDING
FOUNDATION
ROUND
UNDERFLOOR
DATE
IRING
INSPECTOR
FRAME
GATE
DATE
INSPECTOR
'
LATH & PLASTER
FINAL
DATE
DATE
INSPECTOR
INSPECTOR
DATE
INSPECTOR
MAIN DRAIN
DATE
INSPECTOR
ELECTRICAL
INSPECTOR
ELECT.
UNDERG
ROUGH V
FINISH N
FIXTURI
MOTORS
FINAL _
iERVICE
ROUND
DATE
INSPECTOR
IRING
' DATE
INSPECTOR
IRING
DATE
INSPECTOR
5
DATE
INSPECTOR
DATE
INSPECTOR
MAIN DRAIN
DATE
INSPECTOR
DATE INSPECTOR
PLUMBING & GAS
UNDERGROUND
DATE
INSPECTOR
PARTIAL.ROUGH
DATE
INSPECTOR
ROUGH COMPLETE
DATE
INSPECTOR
MAIN DRAIN
'f
DATE
INSPECTOR
GAS PIPING
DATE
INSPECTOR
.e4�
IN5
--31RECTOR
ze
INSPECTOR
MISC
DATE
INSPECTOR
INSPECTED
MISC
MISC
APPLIANCE
DATE
INSPECTOR
DATE I INSPECTOR
INSPECTOR
v
Bldg. Dept.
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
n Sewer Connection Sanitary Permit No.........
N�/PIumbing Final Plumbing Permit No... 7/27-61 ------- --
Owner or Tenant ...L
At
Tract --------------------
Date Connected .........
Date Final
- -
111 12166-1M
Lot No. ----- --,
--------------------------
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------------------------------- 9-!-,?- -4.r. -
. .................................................. 19-6Q,-
-- -----
PLUMBING INSPECTOR