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NO PERMIT NUMBER (2) l0 d $ec I oe At2 f Lot No. No. Street APPLICATION FOR BUILDING PERMIT CITY OF CUPERTINO Q File No. Sanitary No. Data � 196 Application is hereby made for a permit to w astor , Type - O/ 1 to be occupied only as �/ �d • D N in accordance with plot plan, klans and S ecification filed herewith, Estimated Value of Improvements $ FEE$ TJ Pion Check E Owrmr _ Address Contr. /�� •� Address eL Phonj<G State License Approved _ APPLICATION FOR ELECTRICAL PERMIT Date 196 FEE$ 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 Data 196 FEES Cont,. Address Phone State License Approved Applicants agree not to violate any of the Workman's Compensation Laws of the State of California RECORD OF INSPECTION APPROVALS FOUNDATION BUILDING Date Inspector UNDERFLOOR Date Inspector FRAME Date Inspector LATH & PLASTER OCI Dyte � spa etor FINAL Date Insoectar ELECTRICAL ,OUTLETS SERVICE SIZE III 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 8 GAS MAIN DRAIN SIZE I I MATERIAL STORM DRAIN I SIZE I L.M.66TERIAL WATER SYSTEM SIZE IATERIAL TOTAL FIXTURES UNDERGROUND FIXTURE FEE PARTIAL ROUGH Date Inspector MAIN DRAIN FEE ROUGH COMPLETE Dots 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 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