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