NO PERMIT NUMBER (70) 701 Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Sanitary No.
Fila No. �r/ �'� 6
Date 6 196
Application is hereby made for a permit to
'a story, Type
to be occupied only as
in accordance w th Plot Plan, Plans and Specification filed herewith
Estimated Value of Improvements $,
FEE$ Plan Check $
Owner Address p��� /�
Contr. rs_�f � Address 4/ 4 � p�
Phone - S� .�����/ State License as & KI 44- "
Approved ZL)
APPLICATION FOR ELECTRICAL PERMIT
Data 196 FEES
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date 196 GAS FEE $
PLUMBING FEE $
Contr. Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 1% FEES
Contr. Address
Phone State License
Approved
Applicants agree not to violate, any of the
Workman's Compensation Latus of the
State of California
t
RECORD OF INSPECTION APPROVALS
BUILDING
DATE INSPECTOR MISC.
PAD FINAL p
FOUNDATION 1W,71119
UNDERFLOOR
FRAME
LATH & PLASTER
GRADING FINAL
FINAL BLDG.6L 55 J —7D
ELECTRICAL
DATE INSPECTOR MISC.
UNDERGROUND ROUGH
ROUGH WIRING
FINISHED WIRING
i
FIXTURES
MOTORS
FINAL
a
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR MISC.
BACK FLOW REQ.
SANITARY NO.
UNDERGROUND ROUGH /
PARTIAL ROUGH
ROUGH COMPLETE i
MAIN DRAIN
FINAL PLBG. /
FINAL GASB
FINAL APPLIANCE
DATE INSPECTOR MISC.
MISC
MISC
MISC
C - 72
CERTIFICATE OF COMPLETION
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
I
Date ..--5-7//.........7.9........... 49:'......... Building Permit No. .c.....
The BuildingLocated �OS' 7U No, ST- L -e-lta ^ O.
AJat ........... - ....... - .........................................
Owned by ... c;)-2,.T-H 9W A/........4�0_/I/J�rT p- ..�0................................
Has Been (Completed)� IFor Use As: ...r. .......... ...A �-.Tge7
'-'....................................................................................................----.............------.................-
.......------...."-----....."-._...."'-........"`--......"'....................................-----.....................................
.`---.....------------------------------------.....-'----........... ......... ... ........--' --------,-,-...,..-------
BUILDING INSPECTOR