NO PERMIT NUMBER (2) Lot No.
No. Street Y
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Sanitary No,
— , /� File No. V ID �CO
Date . 3 -/2 196
AAA plication is hereby made for a permit to
to be occupied t1uly as
in accordance with Plot Plan, Plans and Specification filed herewith„
Estimated Value of Improvements $
FEES 1`•d&'a Plan Check E
Ow r,er Address
Contr. 2"D 0��//'. Address
Phone -� 7O ��53� State License
Approved -Of 5�
V
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
Contr. 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 FEES
Contr. Address
Phone State License
Approved
Applicants agree not tri violate any of the.
Workman's Compensation Laws of the
State 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.
OTORSFINALPLUMBING. GAS & APPLIANCE
DATE INSPECTOR MISC.
BACK FLOW REO.
SANITARY NO.
UNDERGROUND ROUGH
PARTIAL ROUGH
ROUGH COMPLETE
MAIN DRAIN
FINAL PLBG.
FINAL GAS_
FINAL APPLIANCE
DATE INSPECTOR MISC.
MISC
MISC
MISC
, c
ln�76 Ronewnnd Rd - LOT NO.
NO. STREET
CITY OF CUPERTINO (vAL.2 000
CAP. { SO
i d UAPPLICATION FOR BUILDING PERMIT l EE
w Z Baildine Per.No. 51,10
Date - 'nom
O - t Sanitary Per.No.
W LL JH Repair Roof
3 v Application is hereby made for a permit to
w a. a�2rstoA TjpeQ Structure
xO
0 to be occupied only as Unit Apt. in accordance with
a
'Zw Plans, Specifications and Plot-Plan filed herewith.
a W 2,000
x Estimated Value of Improvements,$
a PI Ck Fee$
p O It is hereby agreed that the requirements of the 20.00
> ut Cupertino Building and Zoning Ordinances and all Fee$
Z5 other laws applicable to the construction,location,and
Z g use of buildings within the City of Cupertino will be Total Fee$
z complied with.
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PHO& STATE LICENSE BUILDING INSPECTOR
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