NO PERMIT NUMBER [ o aC 7 al - %�....: �'✓ Lot No.
No. Street - A
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Sanitary No.
-7 p File No,1 00 Q
Do to �d_ 7 196 .. .. -
- Application is hereby made for¢ permit to - - -
"- a story, Type
to be occupied only as
in accordance with plot plan Plans and Specification filed herewith„
Estimated Value of Improvements $
SZ
FEE$ �+`$3Plan Check $
Owner 4:fV 1-9. Address
Contr. �`-' 4&n-Z;4 �^�/"s./ Address
0Z S—j—
Phone 0 State License
Approved \.�.�.�-�/
l
APPLICATION FOR ELECTRICAL PERMIT
Data 196 FEE$
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
Date 196 FEE$
Contr, Address
Phone State License
., .� Approved' .
Applicants agree not to violate any of the
Workman's Compensation Laws of the -
State of California ,
RECORD OF INSPECTION APPROVALS
BUILDING
DATE INSPECTOR MISC.
PAD FINAL,
FOUNDATION
UNDERFLOOR
FRAME
LATH & PLASTER
GRADING FI
FIN BLDG.
ELECTRICAL
DATE INSPECTOR MISC.
UNDERGROUND ROUGH—
ROUGH'
OUGH
ROUGH WIRING
FINISHED WIRING
FIXTURES
MOTORS
F
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR MISC.
BACK FLOW REQ.
SANITARY NO. .
UNDERGROUND ROUGH—
'PARTIAL
OUGH'PARTIAL ROUGH
ROUGHiPLBG.
LETE
MAIN D
L
FINAL GAS 3T ON l4re JNE1a 11 INJT7f"+- ioN aF N ERAO
—70
LA �Nn2 r m
DATE INSPECTOR MISC.
MISC
MISC
MI SC
GAS SERVICE NOTICE OFFICE
COPY
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
0
To
You are hereby authorized to connect the GAS service for
Owner or Tenant . !. .. ...... ,G ES TTrl
................. ................................................ . ...
At . . . .2.7 ..........7�E1= .y.......w.C .' _.�L.A.UNORY... rn..ON�Y. ....
New Service .._ ...............
No. of Meters .......'............. Reconnect
Move Service .......................
No, of Add. Meters .............. Move ter ........................
PLUMBING INSPECTOR
I
-. P TO l ''ryl +1,' T TIM
11E AM
.,/7 C �Vv PM
K H FROM TELEPHONE NO.OR OPERATOR
o
N OF
S EXTENSION q
i ? E
LU
= Ma
E N
E
M
c SIGNED
.. :O Ph.-d❑' Pt .R.;CMI Pad 0 W..I To Saa Yoe E) Will Call Again C] Was In $A.OD.r.O,