51216, C-46/d k7d I h �P. r s<C
Lot Na.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Dare 196 '—
Application is hereby made for a permit to
a
to be occupied only as
Sanitary No.
File No. 3'� 10'*" -4C
story, Type
in accordance withMiot Plan, Plans and Specification filed herewith,
Estimated Value of Improvements $
FEE$ Plan Check $
Ow r,er Address %�
Contr. LA'fs.a.�. Address jI '�s"`+�
Phone J-13 State License Pe 9 3')el
Approved /
Contr.
Phone
Date ,
Contr.
Phone.
Address
State License
Approved
APPLICATION FOR APPLIANCE PERMIT
196 FEE$
Address
State License
Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State of California
APPLICATION FOR ELECTRICAL PERMIT
Date
196 FEES
Contr.
Address
Phone
State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date
196 GAS FEE $
PLUMBING FEE $
Contr.
Phone
Date ,
Contr.
Phone.
Address
State License
Approved
APPLICATION FOR APPLIANCE PERMIT
196 FEE$
Address
State License
Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State of California
PAD FINAL
FOUNDATION
UNDERFLOOR
FRAME
LATH & PLASTER
GRADING FINAL_
FINAL BLDG._
UNDEF
ROUGE
FINISH
FIXTU
MOT 01
FINAL
RECORD OF INSPECTION APPROVALS
BUILDING
ATE INSPECTOR M
ELECTRICAL
DATE INSPECTOR MISC.
.GROUND ROUGH
-
I WIRING
ED WIRING
RES
IS
PLUMBING, 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
ILM 41