NO PERMIT NUMBER (7) /0320 � Mo.
of
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No. a097
_ (W Sanitary No.
Date '— � 196 -
Application is hereby made for permit to
&L,, ALM a Lary, ype
to be occupied only as
in accordance with Plot Plan, Plans and Specification filed hereAh,
L Estimated Value of Improvements $.3:S-O
FEES v PlanLL hack E
Owner IFOsl"� 42 3
Contr. Address ? Vv/
Phone —:07' Sb State License
Approved
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 to violate any of the
Workman's Compensation Laws of the
State of California
RECORD OF INSPECTION APPROVALS
FOUNDATION BUILDING
Date Inspector
UNDERFLOOR
Date Inspector
FRAME
Date Inspector
LATH 8 PLASTE
!to t / tar
FINAL
Date Insoector
ELECTRICAL
,OUTLETS
SERVICE SIZE
SWITCHES UNDERGROUND
Date Inspector
RECEPTACLES ROUGH WIRING
Dote Inspector
FIXTURES FINISH WIRING
Date Inspector
H.P. CHARGE FIXTURES
Data Inspector i
PERMIT FEE Motors
Date Inspector
TOTAL FEES FINAL
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE I I MATERIAL
STORM DRAIN I SIZE I Lm6TERIAL
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Date Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Do t6 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 Ins pe c far