NO PERMIT NUMBER (3) Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No. Sid 3J'
Data 7 96
r Sanitary No.
�
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 wyG C Plan Check 5
Owr.er // Address A n
Contr. �' e /�f Address
Phone Old' 2, tl� G L State License 3 SC Z-(;
Approved
APPLICATION FOR ELECTRICAL PERMIT
Dote 196 FEES
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING 8 GAS PERMIT
Date 196 GAS FEE $
PLUMBING FEE $
Contr. Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEES
Contr. 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
BUILDING
FOUNDATION
DATE INSPECTOR
UNDERFLOOR
DATE INSPECTOR
FRAME
DATE INSPECTOR
LATH & PLASTER
DATE INSPECTOR
FINAL
DATE INSPECTOR
ELECTRICAL
ELECT. SERVICE
DATE INSPECTOR
UNDERGROUND
DATE INSPECTOR
ROUGH WIRING
DATE INSPECTOR
FINISH WIRING- _
' DATE INSPECTOR
FIXTURES
DATE INSPECTOR
MOTORS
DATE INSPECTOR
FINAL -
DATE INSPECTOR
PLUMBING & GAS '
UNDERGROUND
DATE INSPECTOR
PARTIAL ROUGH
DATE INSPECTOR
ROUGH COMPLETE
DATE INSPECTOR
MAIN DRAIN
DATE INSPECTOR
GAS PIPING
DATE INSPECTOR
FINAL
' DATE INSPECTOR
MISC
DATE INSPECTOR
MISC
DATE INSPECTOR
APPLIANCE
INSPECTED
DATE INSPECTOR
MISC r
DATE I INSPECTOR
MISC
DATE INSPECTOR
MISC
DATE INSPECTOR
111)'Q 94 6` intriv.�v7/% �� LOT NO.
— NO ��6 STREET
CITY OF CUPRTIN04 " �
o` 1t
" .APPLICATION FOR PLUMBIrERMIT
Sanitary No.
Date "/� ' —.t9Permit No. a 3
Fest
tet;
Application is hereby made to the City of Cupertino for a permit to install plumbing
pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
Cupertino,and all other laws applicable thereto. ,r
Use of Work To Bde
mis
Prees Performe
Owner
�C/ Address
APhon . t- �._ �'+
Addrest )ntractor, geState I icense.gfz pp� Approved
Plumbing Inspector
I AGREE I WILL NOT VIOLATE ANY OF THE WORKMEN'S
COMPENSATION LAWS OF THE STATE OF CALIFORNIA.
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