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NO PERMIT NUMBER (8)/ 0 3.2o I / A�n.C.-y.c,- No. Street APPLICATION FOR BUILDING PERMIT CITY OF CUPERTINO No. Fife No. a -F Sanitary No. Date �� jf 196 G Application . he by made for a permit to a story Type to be occupied only as • •. in accordance with Plot plan, P ns and Specification ried herewith„ J� M� Estimated Value of Improvements i FEE$ 01'f- Plan Check $ Owner ��' w'�^ A•as s / O 3 O Contr.•� w�� ///��) ��_ /.��5/ ,Adds Phone lams State License����%% ar Approved W-&21 APPLICATION FOR ELECTRICAL PERMIT Date 196 FEE$ Contr, Address Phone State License Approved t. APPLICATION FOR PLUMBING & GAS PERMIT Date 196 GAS FEE $ PLUMBING FEE $ 1 Contr. Addressf Phone State License 1. Approved APPLICATION FOR APPLIANCE PERMIT Dote 196 FEES Contr. Address Phone Stdte License Approved Applicants agree not to violate any of the Workman's Compensation Laws of the State of California RECORD OF INSPECTION APPROVALS I I MATERIAL .OUTLETS STORM DRAIN BUILDING SWITCHES FOUNDATION Do to RECEPTACLES Inspector ROUGH WIRING Do to) Date 'Inspector UNDERFLOOR PERMIT FEE FINISH WIRING TOTAL FEES Date Inspector Data I ns pe ctor FRAME FIXTURES " Date Inspector Do to r, PERMIT FEE Inspector Inspector LATH 8 PLASTER Date Inspector Data Date FINAL ettor FINAL 01 PERMIT FEE MISC Date Insoe ctor Inspector TOTAL FEE ELECTRICAL MISC Date Inspector PLUMBING & GAS MAIN DRAIN SERVICE SIZE I I MATERIAL .OUTLETS STORM DRAIN I SIZE SWITCHES Do to RECEPTACLES Inspector ROUGH WIRING FIXTURES Date H.P. CHARGE Date PERMIT FEE FINISH WIRING TOTAL FEES Date Inspector Date Inspector PLUMBING & GAS MAIN DRAIN SERVICE SIZE I I MATERIAL UNDERGROUND STORM DRAIN I SIZE I imhLATERIAL Do to REGISTERS Inspector ROUGH WIRING BLOWER FURNACES Date Inspector Date Inspector FINISH WIRING MISC Date Inspector Data Inspector FIXTURES " Date Inspector Date r, PERMIT FEE Inspector Motors Date Inspector Data Inspector FINAL Date Date Inspector PLUMBING & GAS MAIN DRAIN I SIZE I I MATERIAL TYPE OF APPLIANCE STORM DRAIN I SIZE I imhLATERIAL WATER SYSTEM SIZE ATERIAL TYPE OF APPLIANCE TOTAL FIXTURES FEE UNDERGROUND FIXTURE FEE REGISTERS PARTIAL ROUGH BLOWER FURNACES Date Inspector MAIN DRAIN FEE ROUGH COMPLETE MISC Date Inspector STORM DRAIN FEE MAIN DRAIN MISC " Date Inspector WATER SYSTEM FEE r, PERMIT FEE GAS PIPING FLOOR FURNACE Date Inspector GAS PIPING FEE FINAL Date Inspector PERMIT FEE MISC Date Inspector TOTAL FEE MISC 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 r, PERMIT FEE FLOOR FURNACE TOTAL FEE INSPECTED Data -- Inspector