NO PERMIT NUMBER (2) ``,, /J e _ ) /.fin. xn C 7
e2 d�T� � e �j(,(�,�L.M./ s' "\ Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No.
Sanitary No. X(. 7
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 $
FEES �• Plan Check $
Owrre4 '�. Address G 0
Contr. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
Contr, Address
Phone P State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date 196 GAS FEE $
�. PLUMBING FEE x
Contr. Address
Phone — 133 6 State;License
.��
d00
Approved
APPLICATION FOR APPLIANCE PERMIT
Dote 196 FEES
Contr. Address
Phone a .0 State License.
t Approved
Applicants agree not to violate any of the r t
Workman's Compensation Laws of the
State of California ;
RECORD OF INSPECTION APPROVALS
FOUNDATION BUILDING
Date Inspector
UNDERFLOOR
Dote Inspector
FRAME
Dote Inspector
LATH & PLASTER
Date Inspector
FINAL
Date Ins vector
ELECTRICAL
.OUTLETS SERVICE SIZE
SWITCHES UNDERGROUND
RECEPTACLES ROUGH WIRING Date Inspector
FIXTURES FINISH WIRING Dote Inspector
H.P. CHARGE FIXTURES Date Inspector
Date Inspector
PERMIT FEE Motors
TOTAL FEES FINAL Date Inspector
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE I I MATERIAL
STORM DRAIN SIZE I TERIAL
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES . UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Date specter
MAIN DRAIN FEE ROUGH COMPLETE
Id ctor
STORM DRAIN FEE MAIN DRAIN Z00
Date Inspector
WATER SYSTEM FEE GAS PlEING
GAS PIPING FEE FINAL Data Inspector
Date Inspector
PERMIT FEE MISC
Date nspactor
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
Bldg. Dept
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
Sewer Connection Sanitairy Permit No. .......
r C�
r-1 Plumbing Final Plumbing Permit No.. ....I. ... ...C-�
.
LotNo. ._------------- ...............
- ------------------
Owner or Tenant ....... .........( t -------
1- ___ _At ...2o
.--2.C.�-V .4---...I -------------------------- ------------
.... .. ..........
Tract -------------------------- -- - ---- --- -------------------- -`----------------------..:. - --------------------------
DateConnected -------------------------- ---A 1L.(6............... ---- ------ ----------------------- 19."
DateFinal .................... ----------- L-'.. ....... .
PLUMBING IN ECT R
111 7/63-IM