51087 (2) Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No.
�r/,2j Sanitary No.
Date 196 �_
Application is hereby made for a permit to
T
to- Type
to be occupied only as
in accordance with Plot Plan, Plans and Specificati iled herewith]
ra
Estimated Value of Improvements $ f C O G
FEE$ Plan Check $
Owner CT/i-R�-��.//✓ R� Q: Address
Contr. a4u n-.'d "ressry
Phone - "2e(N �V a� State License 102 /n91d 0
(J� /
'
Approved
"Dr
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEE$
Contr, t .
Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Dote 196 GAS FEE $
PLUMBING FEE $
Conte Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEES
Contr. Address
Phone State License a
Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the .
State of California
RECORD OF INSPECTION APPROVALS
FOUNDATION BUILDING
Date Inspector
UNDERFLOOR
Date _ Inspector
FRAME
Dote Ins pe c for
LATH & PLASTER
Date Inspector
FINAL
Date Insoector
ELECTRICAL
,OUTLETS SERVICE SIZE
SWITCHES UNDERGROUND
Date Inspector
'RECEPTACLES ROUGH WIRING '
Date Inspector
FIXTURES FINISH WIRING
Date Inspector
H.P. CHARGE FIXTURES
Date Inspoctor ,
PERMIT FEE Motors
Date Inspector
TOTAL FEES FINAL
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE I I MATERIAL
STORM DRAIN I SIZE I LA6TERIAL
WATER SYSTEM SIZE IIERIAL
TOTAL FIXTURES . UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Date Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Date Inspector
.STORM DRAIN FEE MAIN DRAIN
Date Inspector
WATER SYSTEM FEE GAS PIPING
Date Inspector
GAS PIPING FEE FINAL
Date Inspector
PERMIT FEE MISC
Date Inspector
TOTAL FEE MISC
Date Inspector r
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