51043.1-C320975 I VALLEY GREEN DRIVE Lu 2.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Data 196
Application is hereby made for a permit to
a
to be occupied only as
FEES
Owner
Contr.
Phone
File No. 51o43.1
Sanitary
story, Type
in accordance with Plot Plan, Plans and Specification filed herewith,
Estimated Value of Improvements
5
Plan Check $
Address
Address
State License
Approved _
APPLICATION FOR ELECTRICAL PERMIT
Date 196
FEES
Contr.
Address
Phone
State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
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GAS FEE $
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APPLICATION FOR APPLIANCE IWRMIT
Duro 196
FEES
Co nit.
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
ELECTRICAL
UNDERGROUND
ROUGH WIRING,
FINISH WIRING_
FIXTURES
—
Motors
FINAL
SERVICE SIZE
Date
Date
Date
Date
Date
Inspector
Inspector
Ins pectar
Inspector
Inspector
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
WATER SYSTEM
SIZE
BUILDING
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FOUNDATION
TOTAL FIXTURES
SWITCHES
UNDERGROUND
Date
PARTIAL ROUGH
Inspector
UNDERFLOOR
H.P. CHARGE
Inspector
MAIN DRAIN FEE
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TOTAL FEES
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Inspector
STORM DRAIN FEE
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Date
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LATH & PLASTER
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TOTAL FEE
Date
Inspector
GAS PIPING FEE
Inspector
FINAL
Date
Inspector
Date
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ELECTRICAL
UNDERGROUND
ROUGH WIRING,
FINISH WIRING_
FIXTURES
—
Motors
FINAL
SERVICE SIZE
Date
Date
Date
Date
Date
Inspector
Inspector
Ins pectar
Inspector
Inspector
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
WATER SYSTEM
SIZE
FEE
OUTLETS
UNITS
TOTAL FIXTURES
SWITCHES
UNDERGROUND
RECEPTACLES
PARTIAL ROUGH
FIXTURES
H.P. CHARGE
Inspector
MAIN DRAIN FEE
PERMIT FEE
ROUGH COMPLETE
TOTAL FEES
Date
ELECTRICAL
UNDERGROUND
ROUGH WIRING,
FINISH WIRING_
FIXTURES
—
Motors
FINAL
SERVICE SIZE
Date
Date
Date
Date
Date
Inspector
Inspector
Ins pectar
Inspector
Inspector
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
WATER SYSTEM
SIZE
FEE
TERIAL
UNITS
TOTAL FIXTURES
CIRCULATING HEATERS
UNDERGROUND
FIXTURE FEE
PARTIAL ROUGH
BLOWER FURNACES
Date
Inspector
MAIN DRAIN FEE
SUSPENDED UNIT
ROUGH COMPLETE
MISC
Date
Inspector
STORM DRAIN FEE
AIN DRAINRwA
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WATER SYSTEM FEE
p
A ING J "G (e
TOTAL FEE
Date
Inspector
GAS PIPING FEE
FINAL
Date
Inspector
PERMIT FEE
2,�^
MISC
Date
Inspector
TOTAL FEE
k/ Q%
MISC
uate Inspector
APPLIANCE
TYPE OF APPLIANCE
UNITS
FEE
TYPE OF APPLIANCE
UNITS
FEE
CIRCULATING HEATERS
REGISTERS
BLOWER FURNACES
COMBUSTION VENT
SUSPENDED UNIT
MISC
GAS RANGE
MISC
GAS DRYER
PERMIT FEE
FLOOR FURNACE
TOTAL FEE
INSPECTED
Data Inspector