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NO PERMIT NUMBER (4)No. Street APPLICATION FOR UILDI CITY OF CUPERTI Do to 196 Application isAcrel to he occupied only as FEES Owner Contr Lot No. RMIT File No. Sanitary No. with Plot Plan, Plans and Specification filed herewith lue of Improvements Plan Check $ Address — // Address phone - o2 S '[O � State License Date Approved APPLICATION FOR ELECTRICAL PERMIT 196 FEES Contr. Address Phone State License Approved A-J�TION FOR PLUMBING 8 GAS PERMIT Date 196 lf� GAS FEE $ PLUMBING FEE $ Contr. _ LAr AU4.4 Address — Phone State License Approved 04 o 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 I ,OUTLETS UNITS BUILDING SWITCHES FOUNDATION Lwm.4TERIAL___j RECEPTACLES WATER SYSTEM SIZE ITERIAL Date Inspector UNDERFLOOR FIXTURE FEE PERMIT FEE Date TOTAL FEES Inspector FRAME STORM DRAIN FEE — Dare MAIN DRAIN Inspector Date D t GAS PIPING Inspector LATH & PLASTER � Sa Date � FINAL Inspector PERMIT FEE Inspector Date FINAL Date MISC napector Date Ins nectar ELECTRICAL UNDERGROUND ROUGH WIRING , FINISH WIRING_ FIXTURES_ Motors FINAL SERVICE SIZE Date Inspector Date Inspector Date Inspector Date Date Inspector Inspector Date Inspector PLUMBING & GAS MAIN DRAIN I SIZE I ,OUTLETS UNITS STORM DRAIN SWITCHES I Lwm.4TERIAL___j RECEPTACLES WATER SYSTEM SIZE ITERIAL FIXTURES UNDERGROUND H.P. CHARGE FIXTURE FEE PERMIT FEE MAIN DRAIN FEE TOTAL FEES Date ROUGH COMPLETE Inspector UNDERGROUND ROUGH WIRING , FINISH WIRING_ FIXTURES_ Motors FINAL SERVICE SIZE Date Inspector Date Inspector Date Inspector Date Date Inspector Inspector Date Inspector PLUMBING & GAS MAIN DRAIN I SIZE I I MATERIAL UNITS STORM DRAIN I SIZE I Lwm.4TERIAL___j REGISTERS WATER SYSTEM SIZE ITERIAL TOTAL FIXTURES UNDERGROUND COMBUSTION VENT FIXTURE FEE PARTIAL ROUGH MAIN DRAIN FEE MISC Date ROUGH COMPLETE Inspector STORM DRAIN FEE — Dare MAIN DRAIN Inspector WATER SYSTEM FEE D t GAS PIPING I GAS PIPING FEE � Sa Date � FINAL Inspector PERMIT FEE Date MISC Inspector TOTAL FEE - Date MISC napector ✓ore mspecror 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