NO PERMIT NUMBER (2) /v 3 G S— 7L. — led— a..
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO rr,,
File N.1-60�3 j
Sanitary No.
Date � 196ir
Application is hereb defor pe 't to
a story, Type
to he occupied only
r.lu...rda.pr. Plot Plan, Plans and Specification filed herewith„Estimate nts $
FEES Plan Check $
Owner Address
Conor. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEE$
Contr, Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date 196 GAS FEE E
PLUMBING FEE ''E
Contr. ? �7 Address
Phone —J / �� 3 40 �� State Lice rT3 �a T�7 04
Approved
APPLICATION FOR APPLIANCE PERMIT
Data 196 FEES
Contr, Address
Phone State License
4
Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State of California
RECORB OF IRSPECTION APPROVALS
FOUNDATION BUILDING
Date Inspector
UNDERFLOOR
Date Inspector
FRAME
Date Inspector
LATH & PLASTER
Date Inspector
FINAL
Date Insoector
ELECTRICAL
,OUTLETS
SERVICE SIZE
SWITCHES UNDERGROUND
Date Inspector
RECEPTACLES ROUGH WIRING
Date Inspector
FIXTURES FINISH WIRING
Date Inspector
H.P. CHARGE FIXTURES
Date Inspector
PERMIT FEE Motors
Date Inspector
TOTAL FEES FINAL
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE I I MATERIAL
STORM DRAIN SIZE I imaTERIAL
WATER SYSTEM SIZE JATERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Date Inspector
MAIN DRAIN FEE rl� ROUGH COMPLETE
Date 1 pe to
STORM DRAIN FEE MAIN DRAIN
' Date ns pector
WATER SYSTEM FEE GAS PI G
A
to or
GAS PIPING FEE FINAL t _L
Date Inspector
PERMIT FEE .2 4t, MISC
Date Inspector
TOTAL FEE � 44 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�URNALE I TOTAL FEE IE
INSPECTED
Do to I Inspector
Bldg. Dept
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
lewe, Connection Sanitary Permit No- ----qq-P.q........ .
Plumbing Final Plu lK ing Permit No. ....I...C)C)
Lot No
.
Owner or Tenant . ,---
DSV .... ........
............................... ..
At .........
#---------------- ------a
Tract .............
--- -------------------------------------- . ..... . .. ........
Date Connected ............................. �6 — ------- ---- -- --------------
Date Final ... I
.................................. .........2-r----...... ........ ----- - ----------------- - 19.
---------- ..:-- ----- --- - -
PLUMBING INS E OR
lit 7/63-IM
/03�✓`- lS� Sl, .e470G/�-&41A)VogaZD LOT NO. 2G
NO. STREET
CITY OF CUPERTINO
CAP. {VAL.
d AP/P�,LICATION FOR BUILDIN9 PERMIT t FEE- . 3
f z Date /✓O✓eY✓ 1 3p✓ ��J Iq 7fV Building Per.No. _
z O -'110 Sanitary Per.No.
3 v Appli&at* is- ereby made for a permit to
o� ta�YpTYPe Structure
O a to be occupied onfvas in accordance with
Z H Plans;,$p cifications and Plot-Plan filed herewith.
a uJ
Estimated Value of Improvements,$gU d
LL PI Ck Fee$
_O O It is hereby agreed that the requirements of the /_ 00
a Cupertino Building and Zoning Ordinances and all Fee$
O03 other laws applicable to the construction,location,and
Z 3 use of buildings within the City of Cupertino will be Total Fee$
Z com lid with.
_ a
aO1N1.1FR PHONE
OF DRESS
_ V
PHONE STATE LICENSE BUILDING I SECTOR
8�.