NO PERMIT NUMBER (2) Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No. v' 037
Sanitary No.
Date 196
Application is hereby made for a permit to
a story, Type
to be occupied only as
in accordance with Plot Plan, Plans and Specification filed herewith,
Estimated Value of Improvements $
FEES Plan Check $
OwnerAddress
Contr. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Data 196 - FEES
Cont,. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date IO2 — 196 ` GAS FEE $
�� PLUMBING FEF $
Contr. A4/r".,p�'�^+,-.cia- ' Address
Phone JZ S+._SQ A-0 State License
�/�.�-
Approved �/✓� '� ���
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEES
C ontr. Address
Phone . State License
1 Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State of California
RECORD OF INSPECTION APPROVALS
FOUNDATION BUILDING
UNDERFLOOR
Date Inspector
_
FRAME
Date Inspector
r
D
LATH 8 PLASTER ate Inspector
FINAL Dote Inspector
Date Ins De ctor
_ ELECTRICAL
,OUTLETS
SERVICE SIZE
SWITCHES UNDERGROUND
Date Inspector
RECEPTACLES ROUGH WIRING
FIXTURES FINISH WIRING Date Inspector
' 'H.P:CHARGE FIXTURES Date Inspector
PERMIT FEEMotors Data Inspector
' TOTAL FEES FINAL Date Inspector
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE I I MATERIAL
STORM DRAIN SIZE I Lmhi6TERIAL--j
WATER SYSTEM SIZE TERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE • PARTIAL ROUGH
MAIN DRAIN FEE ROUGH COMPLETE Date Inspector
STORM DRAIN FEE MAIN DRAIN Date Ins Do ctor
WATER SYSTEM FEE GAS PIPING Date Inspector
to or
GAS PIPING FEE FINA — —
PERMIT FEE MISC Date Inspector
Date Inspector
TOTAL FEE M_ ISC
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 PERMIT FEE' /
FLOOR FURNACE TOTAL FEE
INSPECTED
Do to Ins Do ctor _
//�(;•S /��,M4ir/ �L��l LOT NO.
NO STREET
OTT nr�CC7;c;,7^�•> CITY OF CUPERTINO
APPLICATION FOR PLUMBING PERMIT
8 1975
/� (�
Sanitary No.
Date P A A 0 ,19_ Permit No.
Fee s oS�cT s—o
Application is hereby made to the City of Cupertino for a permit to install plumbing
pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
Cupertino, and all other laws applicable thereto.
Use of Work To Be
Premises Performed
C /e
Owner > `�"^-'� r.rl Address
By Address
Contractor,Agent
Phone
State License Approved
Plumbing Inspector
I AGREE I WILL NOT VIOLATE ANY OF THE WORKMEN'S
COMPENSATION LAWS OF THE STATE OF CALIFORNIA.
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/C'.-Coi 'Q. kpli/. LOT NO.
NO. STREET
CITY OF CU.EMNO CITY OF CUPERTINO
APPLICATION FOR APPLIANCE PERMIT
�iFC 5 1975
Permit No.
(� (� —r6
Data Y ^ � '= ,19_ Fee E '�
Application is hereby made to the City of Cupertino for a permit to install gas.
appliances as listed 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.
Use of Work To Be
Premises Performed
Owne; T^ Address
Phone
By Address
Contractor,Agent
Phone
Stale License Approved
,i -"Opium bing Inspector
I AGREE I WILL NOT VIOLATE ANY OF THE WORKMEN'S
COMPENSATION LAWS OF THE STATE OF CALIFORNIA.
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