NO PERMIT NUMBER (2) Lot No.
No. _ Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No. 1117S
Sanitary No.
Date � 196
Application i here by m e for a p rmi o
story, Type
to be occupied only a
'n ecordance with plot Plan, Plans and Specification filed herewith,
Estimated Value of Improvements $
FEES Plan Check $
Owner Address
ell
Contr. Address
Phone State License
Approved
r
APPLICATION FOR ELECTRICAL PERMIT
Data 196 FEE$
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING &GAS PERMIT
Date t9 196 GAS FEE $
PLUMBINGFEE $
Contr. q Address i/2—
Ph6ne �9 3 ' r�9 State License /
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 1% FEES
Contr. ' Address
Phone State License
Approved
Applicants agree not to violate any of the .
Workman's Compensation Laws of the _
State of California
1
— PAD FINAL
GRADING FINAL
RECORD OF INSPECTION APPROVALS
BUILDING
FOUNDATION
Dote Inspector
UNDERFLOOR
Dote Inspector
FRAME
Data Inspector
LATH 8 PLASTER
Date Inspector
FINAL
Date Insoector
ELECTRICAL
,OUTLETS
SERVICE SIZE
SWITCHES UNDERGROUND
Date Inspector
RECEPTACLES ROUGH WIRING
Date Inspector
FIXTURES FINISH WIRING
Date Inspector
H.P. CHARGE FIXTURES
Date Inspector
PERMIT FEE Motors
Date Inspector
TOTAL FEES FINAL
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE I I MATERIAL
STORM DRAIN I SIZE I LwiTERIAL
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES . UNDERGROUND
FIXTURE FEE ' PARTIAL ROUGH
Date -Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Data Inspector
STORM DRAIN FEE MAIN DRAIN
Data Inspector
WATER SYSTEM FEE �'` GAS I PIPING
Date I
GAS PIPING FEE FINAL — —t0
Date Inspector
PERMIT FEE MISC
p9 ate nspector
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