NO PERMIT NUMBER (5) A/47 I �.g L 0 s l� ,cve r �R. Lot No.
No, r .Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Sanitary No.
/ File No. S�/
Do to G 196_r/
Application is hereby made for a permit to
to be occupied my as e A�o�Type S
in accordance with Plot Plan, Plans and Specification filed herewith„
Estimated Value of Improvements $ 1[0Q
FEE$ J M
(/'�f/IJ P � _ O Plan Cheek E
( --
ddess
Contr. �1 Address
Phone -2 (�J Ste to License `T'^ ✓'�'�"`�
� u
Approved
APPLICATION FOR ELECTRICAL PERMIT .;.t
Date 196 FEE$
Conir. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date 196 GAS FEE $
PLUMBING FEE $
Contr. Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEE$
Contr. Address
Phone - State License
»>mr
'Approved
Applicants agree not to violate any of the
Workmen's Compensation Lawsof the
State of California I
RECORD OF INSPECTION APPROVALS,
BUILDING
DATE INSPECTOR MISC.
PAQ FIN4L
A-&tI4 y71
FOUNDATION Of
UNDERFLOOR
FRAME
LATH & PLASTER
GRADINPYINAL
FINAL
ELECTRICAL
DATE INSPECTOR MISC.
UNDERGROUND ROUGH.
ROUGH WIRING
FINISHED WIRING
FIXTURES
MOTORS
FINAL
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR MISC.
BACK FLOW REO.
SANITARY N0. -
UNDERGROUND ROUGH
PARTIAL ROUGH
ROUGH COMPLETE
MAIN DRAIN
FINAL PLBG.
FINAL GAS
FINAL APPLIANCE
DATE INSPECTOR MISC.
MISC
MISC
MISC