FILE 51139 l
Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
• Sanitary No. /
File No. -'r2WY
Do to 196
Application is hereby made for a permit to
Olea story, Type
to be occupied only as
in a cordance with Plot Plan, Plans and S cification filed.herewith,
Estimated Value of Improvements $
FEE$ � Plan Check $
Owner ^ 3
Adrass
Contr. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEE$
Cont,. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date 196 GAS FEE $
PLUMBING FEE $
Cont'. Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEES
Contr. Address
Phone State License
Approved "
Applicants agree not to violate any of the
Workman's Compensation Laws of the'
State of California
{i
RECORD OF INSPECTION 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
oifi-c C.-.I7
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
F] Sewer Connection Sanitary Permit No, -------------
[.Plumbing Final Plumbing Permit No. ..11�.........
Lot No. ...--- ------ ------------
Owner or Tenant ------
At
..........................................................
Tract -------------------------------------------- ----------
Date Connected -------------------- /4
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Date Final ------------------------------
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................... ------- ..lam .........................
"PLUMBING INSPECTOR
111 7/63-1M
°o No. Street�9 Lot No.
l
APPLICATION FOR PLUMBING PERMIT
q 1AN ( 196�CITY OF CUPERTINO
G/.39Sanitary No.
- Date ��•+ ,'1961 .. ./ Permit No 'S
3° Fee $_
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
in accordance with the provisions of the Plumbing Code of the City of Cupertino,and all other
.E laws applicable thereto
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BY Address_
3 Contractor,Aggen
g� ° Phone J 7, ?*—A /` 9
-a State License /L� 2X✓( 1^I:L
Approved
Plumbing Inspector r!/
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