NO PERMIT NUMBER (2) RECORD OF INSPECTION APPROVALS
BUILDING
DATE INSPECTOR MISC.
PAD FINAL
FOUNDATION
UNDERFLOOR
FRAME
LATH 8 PLASTER
GRADING FINAL
FINAL BLDG.
ELECTRICAL
DATE INSPECTOR MISC.
UNDERGROUND ROUGH
ROUGH WIRING
FINISHED WIRING
FIXTURES
MOTORS
FINAL
Tri 2 rroar EI 6�N Goop� oK � �0-64
2 WE�'teRut Z.oe los o is i Z - l6 - 6q 9•`J..
PLUMBIN , GAS & APPLIANCE
DATE I SPECTOR MISC.
BACK FLOW REQ.
SANITARY NO.
UNDERGROUND ROUGH
PARTIAL ROUGH
ROUGH COMPLETE
MAIN DRAIN
FINAL PLBG.
FI S
L APPL IA
DATE INSPECTOR MISC.
MISC
MISC
MISC
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Lot No.
No. Stree
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Sanitary No.
File No.j11�e
Do to / �b 196 4
Application is herr by made for a permit to
a-..�.�— story, Type
to be occupied only as �ra
in accordance th Plot Plan, Plans and Specifics on filed herewith„
Estimated Value of Improvements $
FEE$ of Plan Check $
Owrmr Address �/ p
C ontr, 'y✓�'+�� LAddress s—�s a�
Phone eq 5—.2 7 State License �.S ��� 1 J)91
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEE$
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date 196 GAS FEE $
PLUMBING FEE $
Cont,. 'Address
Phone - State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEES
Contr. Add a's
Phone f 5t to IL.,ce nsa
Appioved
Applicants agree not to violate any of the
Torkman's Compensation Laws of the I
State of California 'F
/�/ ��� �/ ✓L LOT NO,
NO. SnEEI'
APPLICATION FOR PLUMBING PERMIT
" < CITY OP CUPERTINO
W Z i
x o Sanitary No.--
Y �✓
o Date
1 0 ,196 Permit No
W LL
1969 _ Pee8�-4m0
$ O
Application is hereby made to the City of Cupertino for a permit to install plwnbing
o Pipes aptt�kGr 1��rc//�� �pp }��rpe�(r�everse side hereof, and agre' to install said paces
> r .tntl/or fixhtreTin ak�1dT'�YUC7c provisions of the Plumbing Code of the City of
a w Cupertino, and all other laws applicable thereto.
W � 1
� W Use of Premises -
00 �" Address
o a
Owner f ���✓3�`Q .9p7/'n
By /.:'!Ja/ii✓ ;r/ 21-7 4[ 7V4'— Addresses /0;;6 1 lee'2�t/U/'.S�
O CONTRACTOR, AGENT �^
3 � U h i✓�'�o�'t=
- 0 Phone 2-5 - 7 7✓�
w z
W W
u State License -V11 -.�. ['�' Approvedr �
a o
- U PLUMBING INSPECTOR
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