NO PERMIT NUMBER (4)1
/o�s�s
No.
Do to
Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
196
Application is hereby bade for a
to be occupied only s
�t
i a dance I,
Estimate lee of Imp ova ants
FEES
Owner _
Contr. _
Phone ?t
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Lot No
File No�(�,�U%��� l�
Sanitary No.
a i 131 story, Type
Plan, Plans and Specification filed herewith,
S
Plan Check $
Address
Address
State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196
Contr.
FEE$
Address
Phone St o to Li nsa
i
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Ft
A1P P U ING & GAS PERMIT
Dote —=«96 LUi GAS FEE $
G nW6g���������� PLUMBING FEE $ �(/�,/�
Contr.-- o'er Address �� u./Ki�
Phone —S-RR.r •-�sTT �s� State License - ;
r Approved
APPLICATION FOR APPLIANCE PERMIT
Data 1% FEE$
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
,OUTLETS
UNDERGROUND
SWITCHES
BUILDING
RECEPTACLES
FOUNDATION
FIXTURES
FIXTURE FEE
H.P. CHARGE
ROUGH WIRING
Date
Inspector
UNDERFLOOR
Date
MAIN DRAIN FEE
Inspector
FINISH WIRING
Date
MISC
Inspector
FRAME
Date
STORM DRAIN FEE
Inspector
FIXTURES
Data
GAS DRYER
Inspector
LATH & PLASTER
WATER SYSTEM FEE
Inspector
Motors
Inspector
Date
FINAL
GAS PIPING FEE
Inspector
FINAL
Date
Inspector
Date
Ins oactor
PERMIT FEE
ELECTRICAL
Date Inspector
PLUMBING & GAS
MAIN DRAIN
SERVICE SIZE
,OUTLETS
UNDERGROUND
SWITCHES
SIZE
RECEPTACLES
UNDERGROUND
FIXTURES
FIXTURE FEE
H.P. CHARGE
ROUGH WIRING
PERMIT FEE
TOTAL FEES
Date
Date Inspector
PLUMBING & GAS
MAIN DRAIN
SERVICE SIZE
I MATERIAL
UNDERGROUND
STORM DRAIN
SIZE
LoTERIAL
UNDERGROUND
Dare
FIXTURE FEE
Inspector
ROUGH WIRING
BLOWER FURNACES
♦E
Date
Date
MAIN DRAIN FEE
Inspector
FINISH WIRING
MISC
Date
Date
STORM DRAIN FEE
Inspector
FIXTURES
GAS DRYER
-
Date
WATER SYSTEM FEE
Inspector
Motors
TOTAL FEE
Date
Date
GAS PIPING FEE
Inspector
FINAL
Date Inspector
PLUMBING & GAS
MAIN DRAIN
SIZE
I MATERIAL
TERIAL
STORM DRAIN
SIZE
LoTERIAL
UNDERGROUND
WATER SYSTEM
SIZE
FEE
TERIAL
UNITS
TOTAL FIXTURES
CIRCULATING HEATERS
UNDERGROUND
FIXTURE FEE
PARTIAL ROUGH
BLOWER FURNACES
♦E
Date
Inspector
MAIN DRAIN FEE
SUSPENDED UNIT
ROUGH COMPLETE
MISC
Date
for
STORM DRAIN FEE
MAIN DRAIN
GAS DRYER
Date
rolnspector
WATER SYSTEM FEE
GASP NG
TOTAL FEE
Date
Inspector
GAS PIPING FEE
FINAL
Date
Inspector
PERMIT FEE
MISC
r<�
rL
Date
Inspector
TOTAL FEE �
�
MISC
..,..o .. awe. �.
LIANCE
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
n_._ In<nwetnr
7lmga Dea
l
Oif:: Ccpy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO //
r-1SewerConnection Sanitary Permit No.......�sr ta.0...........
P --Plumbing Final Pl etit No. .........
.v, Lot No................................
Owner or Tenant
Tract _-------...1..T`...L.�
DatcConnected ........................ 2'.'......i.......__........__.........................
DateFinal Final ................. ."Z..... .......... ---.....-..................................