NO PERMIT NUMBER (2) 06 i I fl 0- C�
Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No.
ry ' Sanitary No.
Date Z/ 196
Application is hereby made for a permit to
a story, Type
to be occupied only ns
in accordance with Plot plan, flans and Specification filed herewith,
Estimated Volae of Improvements $
FEE$ Plan Check $
Owner Address
Cant, Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
Cont,. Address
Phone State License
T'0'�MA2185WORIFMMBING
Approved
& GAS PERMIT
Date 79 GAS FEE $
Y OF �' G PLUMBING FEE y-Z
Cont,. V ddress '✓+""^"1"j
ak
Ph�a(0—V,13 —U/ ` State License
Approved
APPLICATION FOR APPLIAN E PERMIT
Data 196 FEES
Cont'. 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
FOUNDATION BUILDING
Dote Inspector
UNDERFLOOR
Dote Inspector
FRAME
Date Inspector
LATH & PLASTER
FINAL Dote Inspector
Dote Ins ne c tar
ELECTRICAL
,OUTLETS
SERVICE SIZE
SWITCHES UNDERGROUND
RECEPTACLES ROUGH WIRING Date Inspector
FIXTURES FINISH WIRING Date Inspector
H.P. CHARGE FIXTURES Dot. Inspector
PERMIT FEE Motors Date Inspector
Date Inspector
TOTAL FEES FINAL
Dote Inspector
PLUMBING & GAS
MAIN DRAIN I SIZE I I MATERIAL
STORM DRAIN I SIZE I lawATERIAL
WATER SYSTEM SIZE IATERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE Z120 PARTIAL ROUGH
Dote Inspector
MAIN DRAIN FEE ROUGH COMPLETE
STORM DRAIN FEE MAIN DRAIN Data Inspector
WATER SYSTEM FEE b C) GAS PIPING Date Inspector
GAS PIPING FEE FINAL Date Inspector
PERMIT FEE d 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
Date Inspector
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