NO PERMIT NUMBER (12)/d O/ Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No.
Sanitary No.
Date 196
Application is hereby rhe for a permit to
to be occupied only as
story, Type
in accordanco6d66 Plot Pian, Plans and Specification filed herewith.
Estimated Value o4 Improvements s Add
FEE$ j
Plan Check E
4J .�,�. .
owner. /� ��
Contr.- 1k� / Y Address
Phone O State License /7�
Approved (F
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEE$
Contr.
Phone
Date
Contr.
Phone
Do to
Cont,.
Phone
Address
State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
196 GAS FEE E
PLUMBING FEE $ _
Address
State License
Approved
APPLICATION FOR APPLIANCE PERMIT
1% FEES
Address
State License
Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State of California
RECORD OF INSPECTION APPROVALS
BUILDING
FOUNDATION
UNDERFLOOR
FRAME
LATH & PLASTER
FINAL
ELECT. SERVICE
UNDERGROUND -
ROUGH WIRING -
FINISH WIRING _
FIXTURES -
MOTORS
FINAL
DATE
ELECTRICAL
DATE
DATE
DATE
-STE
o��a
DATE
PLUMBING & GAS
INSPECTOR
INSPECTOR
INSPECTOR
INSPECTOR
INSPECTOR
INSPECTOR
NN SP
I
RGROUND
DATE
INSPECTOR
IAL ROUGH
DATE
INSPECTOR
H COMPLETE
DATE
INSPECTOR
DRAIN
DATE
INSPECTOR
'IPING
DATE
INSPECTOR
L
DATE
- INSPECTOR
DATE
INSPECTOR
INSPECTED
MISC
MISC
MISC
DATE INSPECTOR
APPLIANCE
DATE
DATE
DATE
DATE
INSPECTOR
INSPECTOR
INSPECTOR
INSPECTOR