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NO PERMIT NUMBER (2) Lot No. No.k ;Street APPLICATION R. UI -G PERMIT CITY OF COPE 0 t /' / File ..No. /V a/ODfe t Sanitary No. Date 196 Applic tion is hereby madefa p 't to n story, Type to be oc ied a n. EstJoIn ac rdanae, with Plot Plan, Plans and Specification filed herewith, tted Value of Improvements b FEES Plan Check $ Owner Address Contr. Address Phone State License Approved i �l APPLICATION FOR ELECTRICAL PERMIT Date 196 FEES Contr. Address Phone State License ® Approved la&TrH- P NG & GAS PERMIT Data. VV 11196 GAS FEE $ Cyt Y OF Ir-rs.r�ltet� PLUMBING FEE $ �t Cont,. /(X•,ISVTI"[T/1--ZD �pYw i ��.-�i tNAddress�S�7✓l Phone `j`r" — 1� — 7t��7/State License 4 Approved WLL'AM, D. EIENEVIGF•t APPLICATION FOR APPLIANCE PERMIT Data 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 .APPROVAL FOUNDATION BUIL Dare Inspector' UNDERFLOOR Date Inspector FRAME Date Inspector LATH & PLASTER FINAL Date Inspector Date Ins oe ctor ELECTRICAL ,OUTLETS SERVICE SIZE SWITCHES UNDERGROUND RECEPTACLES ROUGH WIRING Date Inspector FIXTURES FINISH WIRING Dare Inspector H.P. CHARGE FIXTURES Date Inspector PERMIT FEE Motors Dare Inspector Date Inspector TOTAL FEES FINAL Date Inspector PLUMBING & GAS MAIN DRAIN SIZE MATERIAL STORM DRAIN SIZE MATERIAL SP<< WA Se ITEM SIZE MATERIAL TOTAL FIXTURES UNDERGROUND FIXTURE FEE PARTIAL ROUGH pa MAIN DRAIN FEE '� ROUGH COMPL T Date Inspector STORM DRAIN FEE NAI l y is Inspector MAIN DRAIN Date Inspector WATER SYSTEM FEE GAS PIPING Date Inspector GAS PIPING FEE � FINAL ' �i PERMIT FEE MISC Date Inspector yip Dare Inspector L TOTAFEE - / — MISC 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 r GAS DRYER PERMIT FEE FLOOR FURNACE TAL FEE ! iJ INSPECTED �I Date ALInspector 11 Z O G LOT NO. NO. STREET pb 10 CITY OF CU RTINO CAP, v EE-!!6 -- f _'APPLICATION FOR BUILDING PERMIT FEE •S D w Z L'• Building Per.No.� CJV 3 7 0 F Data kri 19�-tC� ,19 T-1 . >< Q P unitary Per.No. 3 v AP�licotion is h�re�j made for a permit to re- rp7 w a-0'story, Type Structure = O 5�D . to be occupied only as in accordance with O a i w Plans,Specifications and Plot-Plan filed herewith. as Estimated Value of Improvements,$ 'r_t' a PI Ck Fee$ p O It is hereby agreed that the requirements of the 22 > w Cupertino Building and Zoning Ordinances and all Fee$ d P- O < applicable to the construction, other laws a ilocation,ana g d 41-6$ ' Z � use of buildings within the City of Cupertino will be Total Fee Z complied with. S in ' _ 10 510. Darr wa of - a ab b �' w w OWNER PHONE ADDRES )15 skarb�k 12na�i "rt a5 �. Suak Q 0 CONTR.OR AGENT DD ['dn'71f7k°t _ ou 37y-/053/ 345 4�9 PHONE STATE LICENSE BUILDING INSPECTOR�Q p LA