336 SIGN PERMIT ' 1
-0 .Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No.
nita ryN A�� o. .�{//
Dote 196 ..S//L— � 3�sP
Application is hereby made for a permit to
to be occupied only as
aCtor anee wit Plot an, Tans rs pecificati on filed herewith
Estimated Value of Improvements $
FEE$ ��+.90 Plan Check $
IQp/C/y�,.er � �s'sft/ i ^• Address �
Contr// ' Q/1Llt .��r� Address
Phone ��, / o d� State License
WILLI^."T Z). C i.i=NIGH
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 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 vinlate any of the
Workman's Compensation Laws of the
State of California
RECORD OF INSPECTION APPROVALS
FOUNDATION BUILDING
Date Inspector
UNDERFLOOR
Date Inspector
FRAME
D to Inspector
LATH 8 PLASTER
at Inspector
FINAL
Date Insoector
ELECTRICAL
OUTLETS
SERVICE SIZE
SWITCHES UNDERGROUND
Date Inspector
RECEPTACLES ROUGH WIRING i
Date Inspector
FIXTURES FINISH WIRING
'I
H.P, CHARGE FIXTURES Date Inspector
Date Inspector
PERMIT FEE Motors
Date Inspector
TOTAL FEES FINAL
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Dote Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Date Inspector
STORM DRAIN FEE MAIN DRAIN
Date Inspector
WATER SYSTEM FEE GAS PIPING
Date Inspector
GAS PIPING FEE FINAL
Dote Inspector
PERMIT FEE MISC
Date Inspector
TOTAL FEE MISC
Date 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
Date Inspector