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51043.1-C420975 I VALLEY GREEN DRIVE Lot No. C-4 No. Street APPLICATION FOR BUILDING PERMIT CITY OF CUPERTINO 1 Date _196 Application is hereby made for a permit to a to be occupied only as FEE$ Owner C on tr. Phone Dot. Contr. Phone Contr. Phone D. to C antr. Phone File No. 5104'3.1 Sanitary N story, Type in accordance with Plot Plan, Plans and Specification filed herewith. Estimated Value of Improvements $ Plan Check $ Address Address State License Approved APPLICATION FOR ELECTRICAL PERMIT 196 FEET 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 Workman's Compensation Laws of the State of California RECORD OF INSPECTION /AP/PROVALS FOUNDATION BUILDING ELECTRICAL Inspector In_ spector Inspector Inspector Ins oector SERVICE SIZE UNDERGROUND Date TERIAL UNDERFLOOR Date ROUGH WIRING FRAME Inspector RECEPTACLES Date LATH & PLASTER Inspector Date H.P. CHARGE Do to FINAL Date Inspector TOTAL FEES Do to ELECTRICAL Inspector In_ spector Inspector Inspector Ins oector SERVICE SIZE UNDERGROUND SIZE TERIAL ,OUTLETS Date ROUGH WIRING SWITCHES Inspector RECEPTACLES FINISH WIRING FIXTURES Inspector Date H.P. CHARGE MAIN DRAIN FEE PERMIT FEE Date Inspector TOTAL FEES Data Inspector ELECTRICAL Inspector In_ spector Inspector Inspector Ins oector SERVICE SIZE UNDERGROUND SIZE TERIAL Inspector Date ROUGH WIRING UNDERGROUND Inspector Date FINISH WIRING BLOWER FURNACES Inspector Date FIXTURES MAIN DRAIN FEE ROUGH COMPLETE Date Inspector Motors Data Inspector Inspector Date FINAL MISC Date Inspector PLUMBING & GAS MAIN DRAIN SIZE MATERIAL STORM DRAIN SIZE MATERIAL WATER SYSTEM SIZE TERIAL TYPE OF APPLIANCE TOTAL FIXTURES FEE UNDERGROUND FIXTURE FEE REGISTERS PARTIAL ROUGH BLOWER FURNACES Date Inspector MAIN DRAIN FEE ROUGH COMPLETE MISC Data Inspector STORM DRAIN FEE MAIN DRAIN MISC 'Date Inspector WATER SYSTEM FEE PERMIT FEE GAS PIPING FLOOR FURNACE Date Inspector GAS PIPING FEE FINAL Data Inspector PERMIT FEE MISC Date Inspector TOTAL FEE - MISC vote 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 Do to Inspector