NO PERMIT NUMBER (3) 2 Z 0'.9,41 l Lot No, f 7
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO �.—� G
File No 6 Q 7
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 $
FEE$ '` /� Plan Check $
Owner �is/fta,&g lIY' �rass
Contr. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
Contr. Address
Phone Stare License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT l
Dote 196 GAS FEE $
PLUMBING FEE $
Contr. / W Address / )07/.7/' 9 X 'Jr
Phone �Z S Q Q State Lice nsa ��L
Approved
APPLICATION FOR APPLIANCE ERMIT
Date 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 APPROVALS
.FOUNDATION BUILDING
Date Inspector
UNDERFLOOR
Data Inspector
FRAME
Date I ns pe c for
LATH B PLASTER
Date Inspector
FINAL
Date InS ae ctor
ELECTRICAL
,OUTLETS SERVICE SIZE
SWITCHES UNDERGROUND
RECEPTACLES ROUGH WIRING Date Inspector
FIXTURES FINISH WIRING Date Inspector
H,P. CHARGE FIXTURES Date Inspector
PERMIT FEE Motors Date Inspector
TOTAL FEES FINAL Date Inspector
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE I I MATERIAL
STORM DRAIN I SIZE I LwATERIAL
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES . UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Date Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Dare Inspector
STORM DRAIN FEE MAIN DRAIN
Date Inspector
WATER SYSTEM FEE GAS PIPING
— D to ns c
GAS PIPING FEE FINAL
Datens pe ttor
PERMIT FEE MISC
Date 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