NO PERMIT NUMBER (2)M
Lot No.
No. Street -
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO t�
File No.
Sanitary No.
Date—!!�lL.c196
Application is hereby.5ade for a permit to
� "` � story, Type
to he occupied only as
in accordance with Plot Plan, Plans and Specification filed herewith,
Estimated Value of Improvements $
FEE$ Plan Check $
Owner .� ,r_��.1 Address
Contr. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEE$
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date 196 GAS FEE $
PLUMBING FEF $
Contr. Address - //J��/
Phone 37 State License
Approved k -
APPLICATION FOR APPLIANCE PERMIT
Date 1% FEES
Contr. Address
Phone State License
f
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
UNDERFLOOR
Date
FRAUF
Data
LATH 8 PLASTER
Date
.....__ Date
ELECTRICAL
Inspector
Inspector
Inspector
Inspector
Ins oa ctor
SERVICE SIZE
UNDERGROUND
SIZE
TERIAL
,OUTLETS
Date
Inspector
SWITCHES
TOTAL FIXTURES
RECEPTACLES
Date
Inspector '
FIXTURES
Date
Inspector
H.P. CHARGE
PERMIT FEE
Date
Inspector
TOTAL FEES
ROUGH COMPLETE
ELECTRICAL
Inspector
Inspector
Inspector
Inspector
Ins oa ctor
SERVICE SIZE
UNDERGROUND
SIZE
TERIAL
TYPE OF APPLIANCE
Date
Inspector
ROUGH WIRING
TOTAL FIXTURES
FINISH WIRING
Date
Inspector '
FIXTURE FEE
Date
Inspector
FIXTURES
Date
Date
Inspector
Motors
ROUGH COMPLETE
GAS RANGE
Date
Inspector
FINAL
STORM DRAIN FEE
Dote Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
WATER SYSTEM
SIZE
TERIAL
TYPE OF APPLIANCE
UNITS
FEE
CIRCULATING HEATERS
TOTAL FIXTURES
REGISTERS
UNDERGROUND
FIXTURE FEE
PARTIAL ROUGH
COMBUSTION VENT
Date
Inspector
MAIN DRAIN FEE
MISC
ROUGH COMPLETE
GAS RANGE
Date
Inspector
STORM DRAIN FEE
MAIN DRAIN
PERMIT FEE
Date
Inspector
WATER SYSTEM FEE
GAS PIPING
Date
s or
GAS PIPING FEE
FINAL "/%"
oy
—
Date
Inspector
PERMIT FEE
e2
MISC
Date
Inspector
TOTAL FEE
P �OI
MISC
vara ins pe cror
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