NO PERMIT NUMBER (67)/o
No.
o I�2 . ,Vi=e �w ,;
Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Date G 196.7?—
Application is hereby made for a permit to
a
to be occupied only as
C_4/
Lot No.
Sanitary No.
File No.
story, Type
in accordan* with Plot Plan, Plans and Specification filed herewith„
Estimated Value o4.lmprovements $
FEE$ Plan Check $
Owner /� .�. Address
6.
Contr. 1 rs�i� Address A
Phone State License ll^4���'�/
Approved K/
APPLICATION FOR ELECTRICAL PERMIT
Date
196 FEE$
Contr.
Address
Phone
State License
Approved
APPLICATION FOR PLUMBING 8, GAS PERMIT
Date
196 GAS FEE $
PLUMBING FEE $
Contr.
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
Latus of the
State of California
PAW rINAL_
FOUNDATION,
UNDERFLOOR
RECORD OF INSPECTION APPROVALS
I
BUILDING
INSPECTOR
FRAME
LATH & PLASTER
GRADING FINAL_
FINAL BLDG.—
UNDEF
"'ROUGI
FINISh
FIXTU
MOT OI
FINAL
ELECTRICAL
DATE INSPECTOR MISC.
GROUND ROUGH—
I WIRING
ED WIRING
RES
:S
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR MISC.
BACK FLOW REQ.
SANITARY NO.
UNDERGROUND ROUGH
PARTIAL ROUGH
ROUGH COMPLETE
MAIN DRAIN
FINAL PLBG.
FINAL GAS 11
FINAL APPLIANCE
DATE INSPECTOR MISC.
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