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NO PERMIT NUMBER (6) / 4Lot No. No. Street APPLICATION FOR BUILDING PERMIT CITY OF CUPERTINO File No. /04'-'), ���� Sanitary No. Date / �'� 196 `S� Application is hereb de for ape i to a story, Type to be occupied only as in accordance with plot plan, Plans and Specification filed herewith. Estimated Valve of Improvements $ FEE$ y��, _ Plan Check $ Ovi^er � .c,"`"'- �— Address Contr. Address Phone State License Approved APPLICATION FOR ELECTRICAL PERMIT Date 196 � // FEES Contr. FyC -64 ,Address �U � L 'I- Phone oG. s �2 '" FDO State License - 77/e (� / Approved v`�//�-� ' APPLICATION FOR PLUMBING & GAS PERMIT Date 196 GAS FEE $ PLUMBING FEE $ Contr. Address Phone State License Approved APPLICATION FOR APPLIANCE PERMIT Dote 196 FEES Contr. Address Phone State License Approved Applicants agree not to violate any of the Wor&man'.c Compensation Laws of the State of California ' RECORD OF INSPECTION APPROVALS FOUNDATION BUILDING Dore Inspector UNDERFLOOR Date Inspector FRAME Date Inspector LATH & PLASTER Do to Ins pe c for FINAL Dare Ins Dector ELECTRICAL ,OUTLETS SERVICE SIZE SWITCHES UNDERGROUND RECEPTACLES ad ROUGH WIRING Date Inspector Data Inspector FIXTURES FINISH WIRING De Inspector H.P. CHARGE FIXTURES kt o, at Inspector PERMIT FEE � Motors P. or TOTAL FEES aZ FINAL n ad Date Inspect PLUMBING & GAS MAIN DRAIN SIZE MATERIAL STORM DRAIN SIZE LIM.6TERIAL WATER SYSTEM SIZE 4TERIAL TOTAL FIXTURES UNDERGROUND FIXTURE FEE PARTIAL ROUGH Date Inspector MAIN DRAIN FEE ROUGH COMPLETE Do to 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