NO PERMIT NUMBER (2) I (/n
Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO !
File No.
j
� Sanitary No.
Do to --x-196
Application is hereby made for a permit to
story, Type
to be occupied only as
in accordance with Plot Plan, PI and Specification filed herewith„
Estimated Value of Improvements S
FEES � a Plan Check S
Owner •L�-cT r.--L�sJ /.[+�C-/E-4!40 "keM.ess
Contr. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
Cont'. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date Vzf 196 7 GAS FEE $
PLUMBING FEE $ It
Phone -7 A-124 ' -3` dodfState License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEE$
Contr. Address
Phone State License
Approved
Applicants agree not to violate any of the
Workman's Compensation Laos of the
State of California
RECORD OF INSPECTION APPROVALS
FOUNDATION BUILDING
Data Inspector
UNDERFLOOR
Dote Inspector
FRAME
Date Inspector
LATH & PLASTER
Date Inspector
FINAL
Date Ins nectar
ELECTRICAL
.OUTLETS
SERVICE SIZE
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 & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
DateInspector
MAIN DRAIN FEE RO H OMPLETE
r
STORM DRAIN FEE p
Dare Inspector
WATER SYSTEM FEE AS PING
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 PEGIT FEE
FLOOR FURNACE TOTAL FEE
t
INSPECTED I
Date I Inspector
a.73 I. Y
OT NO.
NO. STREET
N a —A C.�A,TIkO`N OAR PLUMBING PERMIT
C•.1TY O!i CUPERTINO
F o SEP g 1967 sanitary No. /�33
p LL
° j Date 196— Permit No `f iia
a /� /n� r
3 4 CtTV OF r[#f�{'Pr� lry Pee $7 ��
° Application is hereby mad@ to'the t ity of Cupertino for a permit to install plumbing
o pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
r and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
U)
Cupertino, and all other haws applicable thereto.
w x
� r
Use of Preml s
5 3 Own Address
JJ ,� By Address
COMRACTOR,pAGNT
3 Phone —
ao State License. ApprovePILL1AM U. E�EPIE✓ICH
U PLUMBING INSPECTOR
/ 2 ® ® e« r » g ( Fese �
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Til
Bldg. Dept.
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF PRERTINO
Sewer Connection Sanitary Permit No. - ---------
e"Plumbing Final Plumbing Permit No.,-5./—/.For
LotNo. ........ -------------------
Owneror Tenant - ------ --------------------------------------------------
At --- - -.n----
—
---- -----------------------------------------------
-- -------
Tract ---------------- ........................................----------------
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DateConnected --------------------------- --- --- .............................................................
Date Final .................................. . . ................... -- --
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III 12/66-1m