NO PERMIT NUMBER (2) 10384 Denison Ave.
NO. STREET - LOT NO.
.50
CITY OF CUPERTINO
APPLICATION FOR BUILDING PERMIT
,f
SANITARY NO.
FILE NO. 51.114
i DATE 9/3/75 19
Application is hereby made for a permit to
Remodel 0 1 story,type 5 N. Hr.
to be occupied only as S—Screened Porch
in accordance with plot plan,plans and specification filed herewith.
ESTIMATED VALUE OF IMPROVEMENTS $ 300
FEE$ 5.00 PLAN CHECK$
OWNER 0: K. Stern ADDRESS
PHONEJ'5 Z—ril 3
CONTR. ADDRESS
PHONE STATE LICENSE
APPROVED Semes H. Sisk/h
BUILDING INSPECTION RECORD
DATE INSPECTOR DATE INSPECTOR
FOUNDATION FL TEEL
PRE-GUNITE FRAME
BOND BEAMS LATH
WALLBOARDS-INT.B EXT.
FIREWALLS
MEMBRANE LANDSCAPING
F.M.O.INSPECTION
FINAL BLDG.
UNDER-FLOOR
TIEDOWNS -MIS
DIAPHRAM$
MOORE BUSINESS FORMS INC„LI.
ELECTRICAL INSPECTION RECORD
RESIDENTIAL DATE INSPECTOR COMMERCIAL DATE INSPECTOR
UNDERGROUND ROUGH UNDERGROUND ROUGH
ROUGH WIRING ROUGH WIRING
FINISH WIRING FINISH WIRING
FIXTURES INTERIOR FIXTURES
MOTORS EXTERIOR FIXTURES
FINAL MOTORS
FINAL
MISCELLANEOUS INSPECTIONS
PLUMBING INSPECTION RECORD HEATING&A/C INSPECTION RECORD
DATE INSPECTOR DATE INSPECTOR
BACK FLOW REQUIRED UNDERFLOOR S.M.
BACK FLOW INSTALLED DUCTS&INSULATION
UNDERGROUND ROUGH FLUES&COMB.AIR
PARTIAL ROUGH CONDENSATE DRAINS
ROUGH COMPLETE FINAL APPLIANCE
ROOF DRAIN&LEADERS
MAIN DRAIN
FINAL GAS
FINAL PLUMBING
MISCELLANEOUS
'10
WraG NO. /2�. �m
i/ll�Sr STREET
61
CITY OF CUPEIRINO j, CAP
CIT'PPL"^ ICAr•' _•fi (t
r a Aft FOR BUILDINGPERMIT FEE
w z e'"] f Building Per.No,�� .
w Date SY ( .� yQ7r. 19 �'�
O `�'Zi Sanitary Per.No.
�
3 u Applica on isf
her ee oorr�aa permit
_ O a—story,, Type eZ40l (AWs11JlCiff Structure
u- . to be occupied only osmr KY in accordance with
aI
z o Plans,Specifications and Plot-Plan filed herewi
a u, M
Estimated Value of Improvements,$ .ft
a LL PI Ck Fee$
00 It is hereby agreed that the requirements of the Fee$�
w Cupertino Building and Zoning Ordinances and all
6 a other laws applicable to the construction,location,and Total Fee$ OO
z < use of buildings within the City of Cupertino will be
G z complied with
3 0 � TT[;�2n1 .253 -616-3
w w OWNER PHONE ADDRESS
a' 6
Q 0 CONTR.OR AGENT
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14 i1 PHONE STATE LICENSE BUILDING INSPECTOR
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