NO PERMIT NUMBER (2) / �./k'�/-Q.J Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File Noj�/ Oey
Sanitary No.
Date 196
Application is hereby made for a permit to
a story, Type
to be occupied only as
in accordance with Plot Plan, Plans and Specification filed herewith,
4
Estimated Value of Improvements $
FEE$ Plan Check $
Owner Address
Contr. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Dote 196 FEE$
Conte Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date 196 s_ GAS FEE $
PLUMBING,FEE E VW
• r
Contr. pp �j Address �/ 2`6n�
Phone d 23 / 2�2 T'T✓State License - t2O .Q
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
FOUNDATION BUILDING
Data Inspector
UNDERFLOOR
Data Inspector
FRAME
Date Inspector
LATH R PLASTER
FINAL Da to Inspector
Do to Inoeector
ELECTRICAL
SERVICE SIZE
SWITCHES UNDERGROUND
Dote Inspector
RECEPTACLES ROUGH WIRING
Data Inspector
FIXTURES FINISH WIRING
H.P. CHARGE FIXTURES—
Data Inspector
PERMIT FEE Motors Data Inspector
TOTAL FEES FINAL Date Inspector
Data Inspector
PLL%SIMG 6 GAS
MAIN DRAIN SIZE I I MATERIAL
STORM DRAIN I SIZE I LOTERIAL
WATER SYSTEM SIZE ITUIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE F E I PARTIAL ROUGH
• - Date Inspector
MAIN DRAVII Fait
ROU T
$T04* E IN Do" Inspector
WAIJE J=j M MGAS PIPMA
Daror
GAS PI E FINAL
Date MpeetM
PERMIT FEE MISC
ateMPoster
TOTAL FEE DISC
Dot* 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
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