NO PERMIT NUMBER (2) CPL-4` �� I C Lot No.
No. Street
.APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
- Sanitary No.
G �GJ-
File No.—(—//
Date . 196/
Application is hereby made for a permit to
a tory Type
to be occupied only as
in ace dance with Plot Plan, Plans and Spec' cation filed herewith.
Estimated Value of Improvements $
FEES _ Q I Plan Check $
Owner Address
Contr. Address
Phone Q;L S� L / State License 2
Approved
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APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Data 196 GAS FEE $
PLUMBING FEE $
Contr. Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEES
Contr. Address
Phone State License
Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the
Stoic of California ,
RECORD OF INSPECTION APPROVALS
BUILDING
DATE INSPECTOR MISC.
PAD FINAL
FOUNDATION
UNDERFLOOR
FRAME
LATH & PLASTER
GRADING FINAL
FINAL BLDG.
ELECTRICAL
DATE INSPECTOR MISC.
UNDERGROUND ROUGH
ROUGH WIRING
FINISHED WIRING
FIXTURES
MOTORS
FINAL
PLUMBING, GAS 8 APPLIANCE
DATE INSPECTOR MISC.
.BACK FLOW REO.
SANITARY NO.
UNDERGROUND ROUGH
PARTIAL ROUGH
ROUGH COMPLETE
MAIN DRAIN
- t�IoAlo
FINAL PLBG.
FINAL GAS
FINAL APPLIANCE
DATE INSPECTOR MISC.
MISC
MISC
MISC
- I
Bldg. Dept.
Office Copy
CITY OF CUPERTINO
SEWER-PLUMBING NOTICE
Sewer Connection Sanitary Permit No. t2. - ..'.1�... -------
F-1
--.--.❑ Plumbing Final Plumbing Permit NoAQ. ..Z-I_Z....
LotNo. ...............................
���/Z!1•�7-7er� -----�e
Owner or Tenant .....---.................................-........---
.......--------------.......-----------..------
At ...... ;zd1r"�---- -----�-'-`:-�- -- - .�eA.I.:�...`�...... .....
Tract ---------------. (.0. .......V'G7/1/ ----------------------------------------------.._..
�,, .........1;................ 192 .
Date Connected ...............:...................................../�.%. .....
DateFinal ------------------------------------------------------ ---f.C: .7n7, A/0... .. -- ... 19... �✓
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`/PLUMBING INSPECTOR
o�pa"— I o rerLCLLAw ;L/ LOT NO.
NO. STR F.El
APPLICATION FOR PLUMBING PERMIT
iz
1' OF CUPIiRTINO
Y o ® Sanitary iNo.
0 LL 1
No.-
0 J Da 196— Permit No
a
3U 60
I LL Pee $—,7��/.
0 A11>kk>lic,tin h y�LI-,y��`7�}��`��p,{ City of Cupertino for a permit to Install plumbing
o pit) S� /or tutt�1,61iA1\�everse side hereof, and agrees to install said prices
r I andyIr fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other laws applicable thereto. J
a F Use of Premises . : _. mz &L(
J LL
O 0 AA AQ'n
oa Owner_��/r�� Address�
J
J QpA e' S/oME
z By , �� Address '
0 CONTRACTOR, ENT
3 r-
- m Phone_��
a State License '�-- Approved J
IPLUMBING INSPECTOR
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