51043.3 v2 U / Q Lot No.
No. Street
CITY OF CUPERTINO
APPLICATION FOR BUILDING PERMIT
Sanitary No.
p File NoY Ze�'3 3
Date o �-s/ 19 -7 7
ZA plication is hereby made for a permit to
a _ story, Type
to be occupied only as
in accordance ith plot plan, plans and Specification filed herewith,
Estimated Value of Improvements $
FEE$ Plan Check $
Owner �� Address
Contr. -7 Address -�6 7 � /¢-C sc-
Phone o2 54 6 _ (O�'4 State License ` G
Approved
APPLICATION F ELECTRICAL LECTRICAL PERMIT
Date 19 FEE$
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date 19 GAS FEE $
PLUMBING FEE $
Contr. Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 19 FEES
Contr. Address
Phone State License
Yt. Approved,
Applicants agree not to violate any of the
Workman's Compensation Laws of the I.
State of California
PD-1
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 REO.
SANITARY NO. _
UNDERGROUND ROUGH
PARTIAL ROUGH
ROUGH COMPLETE
MAIN DRAIN
FINAL PLBG.
FINAL GAS
FINAL APPLIANCE
DATE INSPECTOR MISC.
MISC
MISC
MISC