NO PERMIT NUMBER (2) jog Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No.
Sanitary No.
Do to ' 196
Application is hereby made for a permit to '
a 04 story, Ape -7ff
to he occupied only ns
in accordance with Plo tan, Plans and Specificatio filed herewith„
Estimated Value of Improvements I-
F
FEE$ 111111,0111111stal Plan Check $
Owner Address
Contr. + Address
'Phone oZ.f,3 �.3?/ State Lice
n
Approved
Cov
APPLICATION FOR ELECTRICAL PERMIT
Date / `3^' 196 7 FEE$
Contr. ��t- ��"`�-j't ^—�-��� Address [�
Phoney' -3� x-993• State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Data 196 GAS FEE $
PLUMBING FEE $
Contr. Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEES
Contr. Address
Phone State License
r Approved
Applicants agree not to violate any of the .
Workman's Compensation Laws of the
State of California
RECORD OF INSPECTION APPROVALS
FOU DATION BUILDING
VOOR
to pector
Date Inripector
FRAME
Date Inspector
LATH & PLASTER
FINAL Date Inspector
Dote Insoactor
ELECTRICAL
OUTLETS SERVICE SIZE
SWITCHES UNDERGROUND
RECEPTACLES ROUGH WIRING Date Inspector
FIXTURES FINISH WIRING Date Inspector
H.P. CHARGE FIXTURES Date Inspector
PERMIT FEE Motors Dote Inspector
TOTAL FEES FINAL Date Inspector
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Date Inspector
MAIN DRAIN FEE ROUGH COMPLETE
STORM DRAIN FEE MAIN DRAIN Date Inspector
Date Inspector
TER SYSTEM FEE GAS PIPING
Date Inspector
PIPING F E FINAL
Date Inspector _
PERMIT FEE MISC
TOTAL FEE MTSC ate nspector
Dote 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
Pee la�aetor