NO PERMIT NUMBER LQ / V / I ��/�CA� /' "'�-�/ /!1'_"" —�- Lot No, s�
No. •• Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No.J /UOI, .7,
ry Sanitary No.
Dote � r 196 �•'
Application is hereby made for a permit to
a story, Type
to be occupied only as
in accordance with Plot Plan, Plans and Specification filed herewith,.
Estimated Value of Improvements $
FEES Plan Check $
Owner Address
Contr. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Dote - 196 GAS FEE $
PLUMBING FEE $
Contr: Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEES
Contr. Address
Phone State License
1
'Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State of California
RECORD OF INSPECTION.APPROVALS
FOUNDATION BUILDING
Data Inspector .
UNDERFLOOR
Date Inspector
FRAME
Date Inspector
LATH & PLASTER
Date Inspector
FINAL
Date Inspector
ELECTRICAL
OUTUETS-!^.
SERVICE SIZE
SWITCHES' UNDERGROUND
Date Inspector
RECEPTACLES ROUGH WIRING
Date Inspector
FIXTURES. FINISH WIRING
Date Inspector
_]
H.P. CHARGE FIXTURES
Date Inspector
PERMIT FEE Motors
Date Inspector
TOTAL FEES FINAL
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL —
STORM DRAIN SIZE MATERIAL
WATERS YSTEM SIZE_ ITERIAL
TOTAL FIXTURES ,UNDERGROUND
FIXTURE FEE PARTIAL ROUGH -
Date Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Do to Inspector
STORM DRAIN FEE MAIN DRAIN
Date Inspector
WATER SYSTEM FEE GAS PIPING
Date Inspector
GAS PIPING FEE FINAL
Date Inspector
PERMIT FEE MISC
Date Inspector
TOTAL FEEMISC
Date Inspector
010101110
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 —
Dote Inspector
OFFICE COPY
Jam`" BUILDING
SERVICE NOTICE
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
..........�.... . .. ......
1..... ....... 1961...
...... ..
TO I
You are hereby ize to connect elect .cal/fervice for
C�� cl,
e
Owner or Tenant ..... . . ...........Z .................
At ...........I.C)....... L-4.'X"
7�..-X.... ......... .......
No. of Wires ........................ Size of Wires ... ... Size of Switch
Motor Load .......................... Voltage ................................ Phase ..................................
Heating Load ........................ K. W. ..... ....... ................... Voltage ................................
Ltght
No. of Meters.... ........... 110............
... m Service................ Rmnnect.................
Heat..........., 220............ Thr ire.............. Move Service............
.-No.of Add.
Power..011�
............. ............. Move Meter..............
........... .................... ...............
...............- ...........
ELECTRICAL I E R
MV