51216-C-510 t 701 A .
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Date 196
Application is hereby made for a permit to
a
to be occupied only as
e Lot NV
Sanitary No.
File No.
story, Type
in accordance wk/ Plot Plan, Plans and Specification filed herewith,
Estimated Value of Improvements . $
FEES Plan Check $
Owrrer% _ '_, "n— - ` Address M
Comr. _JC "�/ .t.�.�/`+�' • Address ��4,4��1 >,---
Phone V 3 �J State License
ALA: T
Approved /s/ /
Cont,.
Phone
Date
Contr.
Phone
Address
State License
Approved
APPLICATION FOR APPLIANCE PERMIT
196 FEES
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 $
Cont,.
Phone
Date
Contr.
Phone
Address
State License
Approved
APPLICATION FOR APPLIANCE PERMIT
196 FEES
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.
UNDER
ROUGF
FINISH
FIXTU
MOT OF
FINAL
RECORD OF INSPECTION APPROVALS
BUILDING
DATE INSPECTOR MISC.
ELECTRICAL
DATE INSPECTOR MISC.
GROUND ROUGH -
WIRING
ED WIRING
RES
S
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR MISC.
BACK FLOW REO•
SANITARY NO.
UNDERGROUND ROUGH
PARTIAL ROUGH
ROUGH COMPLETE
MAIN DRAIN
FINAL PLBG.
FINAL GAS
FINAL APPLIANCE
DATE INSPEC
MI