NO PERMIT NUMBER (2) Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO !
File No. S—ld7/6
h� Sanitary N—.
Date a -5'- 196.L
Application
y _ is hereby made for a permit to
a story, Type
to he occupied only as
in ar.cordance with Plot Plan, Plans and Specification filed herewith.,
Estimated Value of Improvements $ 6, U00. -�-
s
FEES �� O� // / Plan Check $
Owner / /41'2 �C�C/ Address
Contr, Address
Phone State License ;2 d/�J-�-2 97
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEE$
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 to violate any of the
Rlorkman's Compensation Laws of the
State of California
RECORD OF INSPECTION APPROVALS
BUILDING
FOUNDATION 7 ��
DATE C�7; CTOR
UNDERFLOOR - -' Lt7
_ �pq TE IN SPE TOR
FRAME GG 7
DATE INSPECTOR
LATH & PLASTER
DATE INSPECTOR
FINAL
DATE INSPECTOR
ELECTRICAL
ELECT. SERVICE
DATELINSPECTOR
ECTOR
UNDERGROUND
DATEECTOR
ROUGH WIRING
DATE
FINISH WIRING
DATEECTOR
FIXTURES
ECTOR
MOTORS
ECTOR
FINAL
PATE INSPECTOR
PLUMBING & GAS
C-N-AftGRO
DATE INSPECTOR
PARTIAL ROUGH
DATE INSPECTOR
ROUGH COMPLETE
DATE INSPECTOR
MAIN DRAIN
DATE INSPECTOR
GAS PI PIN
DATE INS OR
FINAL
DATE IN ECTOR
MISC INSPEC R
DATE
MISC ' DATE INSPECTOR
APPLIANCE
INSPECTED DATE INSPECTOR
MISC
DATE INSPECTOR
MISC
DATE INSPECTOR
MISC--'_��-I DATE INSPECTOR
GAS SERVICE NOTICE OFFIC
OPYE
C
BUILDING INSPECTOR'S OFFICE
CITY OF CUPE T
.................. ........ .............
To
You are hereby authorized to connect the GAS service for
Owner or Tenant . ............ ........ ...........
Ate.0 ........................................
New Service .............I............
00' Me Reconnect .............................
Move Service ...... .. ...
No�, Move Meter
PL BING INSPECTOR
LQ -70 (p I Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No.
�/S<O YG
Sanitary No.
7
Date 196
Application is hereby made for a permit to
a story, Type
to he occupied only ns
in accordance with P Plan, Plans and Specification filed herewith„
Estimated Value of Improvements $ �, 000
eaZ/
FEES Plan Check $
Owner Address �
Contr. �iC�.t..(:C.u.-r.J �ru'�`.►.ddress 3(0 J 041 /\t.-� "
Phone _. 3 4/2 -96R/ State License soflfll " 7
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEE$
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 FEE$
Contr. Address
Phone State License
Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State, of California
RECORD OF INSPECTION APPROVALS _
FOUNDATION 0 — 7-1 BUILDING
04-� _ Ins pa cto
UND R L L
Inspactor
FRAME
Date Inspector
LATH & PLASTER
Date Inspector
FINAL
Dote Ins oector
ELECTRICAL
,OUTLETS
SERVICE SIV
SWITCHES UNDERGROUND It
C1pt= Inspector
RECEPTACLES ROUGH WIRING �{/ 07
Date Inspector
FIXTURES FINISH WIRING
Date Inspector
H.P. CHARGE FIXTURES-
Date r
PERMIT FEE Motors
Inspector
Date
TOTAL FEES FINAL i r�
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
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
Date Inspector
WATER SYSTEM FEE GAS PIPING
Date Inspector
GAS PIPING FEE FINAL
Date Inspector
PERMIT FEE MISC
Date Inspector
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
Date Inspector
r� 07c LOT NO. /�-r
M
No I STREET
W z AATION FOR BUILDING PERMIT
xO
rc „ ?MCUPERTINO
pa 1 LL Uateermit No
ApplicationTI to
oa aV
z�, CI��as �ry, Building
a w
to be occupied only as in accordance with
0 o Plans, Specifications and Plot-P filed herewith. M Pl Ck Fee _—Td
> "; Estimated Value of Improvements, S O �. Fee$ O?/
oa
z J It is hereby agreed that the reyui rements oft Cupertino Building and Zoning Ordinances and
J , all other la applicable to the con it ;(tion, cation, and use of buildings within the City of
d o Cupertino I e annplie s
3 a caner—� Address
W Z
W By Address
u P Vz_ Approv
State License, Bull. we INSPECTOR
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