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NO PERMIT NUMBER (2) �//6 I �j6r�•�yy�,,,st/ �/Ls„V.,.�/ Lot No. No. Street APPLICATION FOR BUILDING PERMIT CITY OF CUPERTINO File No. QJ •/ Sanitary No. Do to 7 L 196 1 Application is hereby made for a permit to story, Pyne to be occupied only as `20-w "K/ in accordjWce with Plot Plan, Plans and Specification filed herewith„ Estimated Volvo of Improvements $ 7d d FEES Z d`• Plan Check $ Owner Doe Address Address /' Contr. /�-•+�atl 9 IA�Wfs�.r.-e Address 4'f—d /�+a� Phone A—P` 'EYS State License "'� O Approved L APPLICATION FOR ELECTRICAL PERMIT Date 196 FEES Contr. Address Phone State License Approved APPLICATION FOR PLUMBING & 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 8 PLASTER J DATE IN SPE FINAL J 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 DATE INSPECTOR MISC ' /? DATE INSPECTOR MISC DATE INSPECTOR 11164 La Paloma Drive LOT NO. NO. STREET CITY G CU.- CITY r CITY OF CUPERTINO PLICATION FOR APPLIANCE PERMIT SFP 9 19715 Permit No. )ate l5e3kt'1 ID ,q 76 Fee$ —�' Applicol on� hirel? made to the City of Cupertino for a permit to install gas, appliances as_fisted on the reverse side hereof, and agrees to install said appliances in: accordance with the provisions of the Plumbing Code of the City of Cupertino, and all, other laws applicable thereto. ase of Work To Be Replacement Furnace sremises Residence Performed owner nalri r] ThgmnS; Address 11164 La Paloma Drive 'hone 446-1040 aY Valley Heating Address63' N. 13th St. San Jose 2 n 4ontya�c�tor,2 gent phone 7 b 7Q�� itate License 2 58 540 Approved •"'���- 4, Plumbi ctor I AGREE I WILL NOT VIOLATE ANY OF THE WORKMEN'S 1 COMPENSATION LAWS OF THE STATE OF CALIFORNIA. C� ®LA 0 00 W � M N F_ Z 4 � o O n Z J p � a u U $ O W W a Z o z O i z O Z C N N m m O Z O w O 1 N N Q m N U' >O aa a o p O j OZa a Zp 0Z auuJ¢2w wz 0NZi0 Z O Jj Z ZS Za S F 2 a OR. o^ LL $u 3LLz p Qo op 0 F OpZ $ aiZ < ZUOiS 3FpzOO � Z 0O ZQZNU J maLLo aO0 0 0 $T . M .0 0 Z LL yNZp F U Zm Z O 0O0mONN � O _ OaaUFa- > > J> > p,mmF>. Ll Q 2 p V N fl O N .O n m P O N ('1 Y N O n 63 P