NO PERMIT NUMBER (2) 1oS5�D I �I �C a� p Lot No.
No. Street
CITY OF CUPERTINO
APPLICATION FOR BUILDING PERMIT
Sanitary No.
p File No.���3
Date a �'-S� 19 7e2.J
Application is hereby made for a permit to
('
to be occupie only as a story Typ®
in accordance with Plot Plan, Plans and Specification filed helellvitk
Estimated Value of Improvements E C' '
—b
FEES Plan Chock $
Owner �� Address
Boner. /)N =01^- -address
Phone a S _ /� State License-/_ _�7`j'�'e7 A"`-�-�.•..•/�
Approved `
APPLICATION FOR ELECTRICAL PERMIT
Data 19 FEE$
Co ir. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Data 19 GAS FEE $
PLUMBING FEE $
Contr. Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 19 FEE$
Contr. Address
Phone State License
Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State of California
PDA
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 & APPLIANCE
DATE INSPECTOR MISC.
BACK FLOW REO.
SANITARY NO.
UNDERGROUND ROUGH
PARR RRpOOUGH
R OU C OMDLE y
MAIN DRAIN
FINAL PLBG. "
FINAL GAS
FINAL APPLIANCE
I
DATE INSPECTOR MISC.
MISC
i
MISC
r
MISC
T /A 6- _ 0 Pb,oTiT / A uC LOT NO. i
NO. STREET
N
w Z CtfT OF CU?E�IiNA CITY OF CUPERTINO . 0
¢o
O JAUC7 2J 1972 APPLICATION FOR BUILDING PERMIT
Building Per. No.
W O De,a Sanitary Per.No.
o Application is hereby made for a pe mit to
O a_story, TypeFI-IL / Structure
>a71
Z
0 to be occupied only as
in accordance with
W
a Plans, Specifications and Plot-Plan filed her ith. PI Ck Fee$
J
'
go Estimated Value of Imprqvements, $� `�_ Fee$
� >� Total Fee$
O�
oa ..
Z It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances
o and all other laws applicable to the construction, location, and use of buildings within
3 a the City of Cupertino will be complied with.
W
Z Owner's J� Address
W
_ ary
O U By t ' I Atldress
GD
_O Cantr, orr gent.
(hone �f J �g Approved IV
\d/ �/ A / /9 ?,3i20 Building inspector
Stets License
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