NO PERMIT NUMBER (2) 9
/ 0 I / /�/��/ �./`AA�✓ Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO 7
File No. Sim �I
Sanitary No.
Dare 196 J
A l n is hereb m e for a per t t
n .story, Type
to be ncc up r only ns �
in �ccardance with Plot Plan, Plans and Specification filed herewith,
Estimated Value of Improvements $
FEES Pion Check $
Owner Address
Contr. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
Contr. Address
Phone u Stare License
LLNG
Approved
IROM,JL te & GAS PERMIT
Data 196 GAS FEE $
nCIITTY^-�(/�)[ CUPS-RTi 14 PLUMBING FE-E7 $ ^Q��
Cont,. v' ��'« d" rass �
Phone A9,f-.3 PC.35 / State License
f� Approved WILLIAM D. SENEVICH
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEES
Conrr. 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
Date Inspector
UNDERFLOOR
Date _ Inspector
FRAME
Data Inspector
LATH & PLASTER
Dote Inspector
FINAL
Date Inspector
ELECTRICAL
,OUTLETS
SERVICE SIZE
SWITCHES UNDERGROUND
RECEPTACLES ROUGH WIRING Date Inspector
FIXTURES FINISH WIRING Date Inspector
H.P, CHARGE FIXTURES Date Inspector
Date Inspector -
PERMITTEE Motors
Date Inspector
TOTAL FEES FINAL
Date _. Inspector
PLUMBING & GAS
MAIN DRAIN SIZE I I MATERIAL
STORM DRAIN I SIZE TERIAL
WATER SYSTEM SIZE IATERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Date Inspector
MAIN DRAIN FEE ROUGH COMPLETE
STORM DRAIN FEE MAIN DRAIN Data Inspector
WATER SYSTEM FEE 04GAS PIPING Date Inspector
Date Inspector
GAS PIPING FEE .FINAL g '
Date Inspector
PERMIT FEE, too MISC '
Dote Inspector
TOTAL FEE � 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
GAS DRYER PERMIT-FEE
FLOOR FURNACE TOTAL FEE
INSPECTED
Date _ Inspector