NO PERMIT NUMBER (2) 103 O d I Lot No,
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No.
Sanitary No.
Date 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 $
Q/ .�
Droner Address
Contr. Address
Phone State License
Approved
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APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEE$
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date� 196 nal—
GAS FEE $
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Contr. g: _ � �"IFECt�pC` .'�r7��y/fVJrQ(/
Phone j 0
Stafe License
I�^y
Approved — s/✓�/>�
APPLICATION FOR APPLIANCE PERMIT �I1L
Data 196 FEE$
Contr. Address
Phone State License
Approved
Applicants agree not to violate any of the
Workman's Cnmpensalion Laws of the
State of California ..
RECORD OF INSPECTION APPROVALS
BUILDING
FOUNDATION
Data Inspector
UNDERFLOOR
Date Inspector
FRAME
Date Inspector
LATH 8 PLASTER
OU
I Spector
FINAL
6.to I Insoecto
ELECTRICAL
OUTLETS
SERVICE SIZE
SWITCHES UNDERGROUND
Dote Ins pe c for
RECEPTACLES ROUGH WIRING
Date Inspector
FIXTURES FINISH WIRING
Date Inspector
H.P.CHARGE FIXTURES
Dote Inspector
PERMIT FEE Motors.
Data Inspector
TOTAL FEES FINAL
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE I I MATERIAL
STORM DRAIN SIZE I IMMMTERIAL
WATER SYSTEM SIZE iTERIAL
TOTAL FIXTURES . UNDERGROUND
FIXTURE FEE �� PARTIAL ROUGH
Date Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Date Inspector
STORM DRAIN FEE MAIN DRAIN
' Dote Inspector
WATER SYSTEM FEE �� GAS PIPING
Date Inspector
GAS PIPING FEE FINAL
Date Inspector
PERMIT FEE eZ.aL MISC -
ata 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
/6 JOJ I (f L_/-) LOT NO.
crWO1 CUPWtHa"',
Q ���►�pL �TIONFOR AuPP RTANoCE PERMIT
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Date Q 344 P Permit No.
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_ `o Fee Y
LL W Application is hereby n7m* to the City-of Cupertino for a permit to
o i install gas appliances as listed on the reverse side hereof, and agrees to
<w ' install said appliances in accordance with the provisions of the Plumbing
_ 1, Code of the City of Cupertino, and all other laws applicable thereto.
LL
Use of Premises tl —.7-
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w' Owner Cq 1220E �• CczEm p,U Address/6,72-1 CFtF.eRY �� ti
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CONTRACTOR,AGENT SR7U ,fOI F
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Phone 211- �SI �
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W.W
oState License 2SSS�t Approved
U PLUMBING INSPECTOR
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CITY OF CUPERTINO
10300 Tore Ave.'
CORRECTION NOTICE
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Department f
Job Located at .L�3..�P ............._ <4u '4...
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You are hereby notified that no more work shall be
done until the above violations are corrected. When
corrections have ,been made call the inspector
252.4505 Date: ......9j-��./ ---z7
City Telephone Inspector: .. f �(��!-