NO PERMIT NUMBERStreet
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Date , G 196 —7 --
Application is hereby made for a permit to
a
to be occupied only as
Lot No.
Sanitary No. G / (a
File No.J-�
story, Type
in aAcordance with Plot Plan, Plans and jfecification filed herewith,
Estimated Value of Improvements $
FEE$
Plan Chock $
Owner Address '
qq � / $
Contr. _L�!L � Address 9.0
Phone 3 %
State License Z Z d 7 J f,
e
Approved
Date
Contr
Phone
Do to
Lontr.
Phone
Do to
Contr.
Phone
APPLICATION FOR ELECTRICAL PERMIT
196 FEES
Address
State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
_ 196 GAS FEE $
PLUMBING FEE $
Address
State License
Approved
APPLICATION FOR APPLIANCE PERMIT
196 FEES
Address
State License
Approved
Applicants agree not to violate any of the
Workmnn's Compensation Laws of the
State of California
PAD FINAL
FOUNDATION
UNDERFLOOR
FRAME
LATH & PLASTER_
GRADING FINAL_
FINAL BLDG.
UNDER
ROUGI
FINISH
FIXTU
MOT Of
FINAL
RECORD OF INSPECTION APPROVALS
BUILDING
INSPECTOR MI
ELECTRICAL
n ATF INSPECTOR MISC.
GROUND ROUGH
-
I WIRING
ED WIRING
RES
;S
SANITARY NO.
UNDERGROUND ROUGH
PARTIAL ROUGH
ROUGH COMPLETE
�_
MAIN DRAIN
FINAL PLBG.
FINAL GAS
FINAL APPLIANCE _
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR MISC.
SPECTOR MISC.
1
No. Street Lot No.
o — §
P TION FOR PLUMBING PERMIT
E® (. CITY OF CUPERTINO
U 111 AN 1.3 1969 G /4 .3 r3�
Sanitary No. _
EU 96 _ Permit No..�/
0
4.E i 1 CUPERTM
3 Fee $
r 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 prices and/or fixtures
A in accordance with the provisions of the Plumbing Code of the City of Cupertino, and all other
A laws applicable thereto.
0
0
U 0 Use of Premises
o y Owner Address:Z as G ,�l//r',f eY2�
/y
.3 By.tlr %/U/' /^ Address,,
.. Con ractor, Agent
v_
Phone .
i .,2State Licensel^2 rl Approved{ ti
�j-- Plumbing Inspector /�