NO PERMIT NUMBER (2) /0/00 I �,�/ /Cyr Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No.
Sanitary No.
Data 196
Application is hereby made for a per"". o
a ry, Type
to be occupied only as
in accordance with Plot Plan, Plans and Specification filed herewith,
Estimated Value of Improvements $
FEES T —��^�-�s�/I e_ Plan Check $
Owr,er —$ �G�.A
Contr. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196—L . FEES J7MI �y•v
Contr. Address 1*441
Phone t�s JIL— /OV O State License
Approved
`�'�,1�V
Approved ` I� •"�^'�
APPLICATION FOR PLUMBING & GAS PERMIT
Date 196 GAS FEE $
PLUMBING FEE $
Contr. Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEES
Cont,. 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 BUILDING
Date Inspector
UNDERFLOOR
Date Ins pe bt or
FRAME
Data Inspector
LATH & PLASTER
Date Inspector
FINAL
Dote Ins oe c for
ELECTRICAL
,OUTLETS
SERVICE SIZE
SWITCHES UNDERGROUND
Date Inspector
RECEPTACLES ROUGH WIRING
Date Inspector
FIX,TURES FINISH WIRING
Date Inspector
H.P HARGE FIXTURES
Data Inspector
PERMIT FEE 40 Motors
2 Da c r
TOTAL FEES L' FINAL '
Dote Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Dote Inspector "
MAIN DRAIN FEE ROUGH COMPLETE
Dote 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
Dote 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
Data Inspector