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NO PERMIT NUMBER (3) _//Q 10 I >z . Lot No. No. Street APPLICATION FOR BUILDING PERMIT CITY OF CUPERTINO Sanitary No. Date 196 File Nl A-�a'� O � ' Application is hereby made for a permit to O �—SLOT. Type to 6e occupied only as C2==Qy in accordance with Plot Plan, Plans ars Specification filed herewith, Estimated Value of Improvements $ FEE$ – � Plan Check $ Owner �+� � Address �� �/ � Contr. Address IFP`p.T�'�./� Phone 01L 9 77 State License Approved APPLICATION FOR ELECTRICAL PERMIT Data 196 FEE$ Contr. Address Phone State License Approved APPLICATION FOR PLUMBING & GAS PERMIT Dote 196 'GAS FEE $ PLUMBING FEE $ Cont% Address Phone State License Approved APPLICATION FOR APPLIANCE PERMIT Date 196 FEE$ 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 BUILDING DATE INSPECTOR MISC. PAD FINAL FOUNDATION UNDERFLOOR FRAME LATH & PLASTER GRADING FINAL FINAL BLDG. ELECTRICAL ATE INSPECTOR MISC. UNDERGROUND ROUG ROUGH WIRING FINISHED WIRING FIXTURES MOTORS- FINAL- PLUMBING, OTORSFINALPLUMBING, GAS & APPLIANCE DATE INSPECTOR MISC. BACK FLOW REQ. SANITARY NO. UNDERGROUND ROUGH PARTIAL ROUGH ROUGH COMPLETE MAIN DRAIN FINAL PLBG. FINAL GAS FINAL APPLIANCE DATE INSPECTOR MISC. MISC MISC S MISC IN 0. �� L� LOT NO. N Q r o �P ION FOR ELECTRICAL PERMIT a _ p*`— o J t 'ITY OF CUPERTINO 3a W W O G / 19; !b o F rT Permit No. O v r Fee ti Z w rt4li�{@n 1�EKWD the City of Cupertino for a permit to install electrical WarTB;or xtnres as listed on the reverse side hereof, a d agrees to install said 20 wiring and/or fixtures in accordaric with the provisions ofectnc. �jod�°f t`h�� > W City of Cupertino, and al cher !asys applicable thereto. wo ZJa Use of Premises _ J Z J G 3 < Owners Address a By � a�4 ' - AddressRINSPEC:rORK U' I CONTRACTOR, AGENTApprovedELECTR State License�"�U7�ci-C/V v M1Yl �CC�) Size Service Conduit----------------------Number of Outlets-------a-2------ -.-----.-- ---------- Size Service Wires--------------------------Number of Switches................ .......... .......... -..._-.-..... Size Service Switch........................Number of Receptacles............ .......... .......... ....... OT/ Size Sub Feed Conduit------------------Number of Fixtures...... ..... .......... . Size Sub Feed Wires....................Ranges---------------- KW.............. .......... .......... ........---. Numberof Circuits------------------- Oven ------------ KW.............. .......... .......... .............. Number of Meters........................Signs.......... Transformers........ .. ....... .......... .............. Misc------------------------ ------Dryers_---.......-.-.-....._.........--- ---- ------ - Motors.................... HIS------------------.- Phase.................... Permit Fee Motors-------------------- HP.................... Phase--.....----.-.....-- Motors.................... HP------------------- Phase.................... H P Charge-------------- ..--...-- TOTAL FEES w RECORD OF INSPECTION APPROVALS RoughWiring................I---------------------------- Fixtures ...... ...............I..................... ...... DATE INSPECTOR DATINSPECTOR Finish Wiring ......---......I---------------------- otors - -----I.-...-------------....... DATE INSPECTOR DATE INSPECTOR Final -..--..._...------....I---- --------------------- OATE INSPECTOR