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NO PERMIT NUMBER (2)No. FEES Ow r.e r Contr. Phone Street APPLICATION FOR BUILDING PERMIT CITY OF CUPERTINO 1 File NoAgo, Q Sanitary No. _196 App 'ca ' is ereby made for a permit to story, Type 5 Specification filed herewith, 3V% License Approved ®a0 h, E t_ ASEP 219064 APPLICATION FOR ELECTRICAL PERMIT Data =6IJPERINI FEE$ _ 3:: CantL._ a Ad I P'�i\one+�.% State License \� Approved ` APPLICATION FOR PLUMBING & GAS PERMIT Dot* 196 GAS FEE E PLUMBING FEE E Contr. 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 a N! RECORD OF INSPECTION APPROVALS FEE FOUNDATION UNITS BUILDING SWITCHES Date Date RECEPTACLES WATER SYSTEM SIZE Inspector UNDERFLOOR Date Inspector' H.P. CHARGE FIXTURE FEE Inspector Dote FRAME TOTAL FEES Data ROUGH COMPLETE Inspector !STORM DRAIN FEE Date Data MAIN DRAIN Inspector Motors Data, GAS PIPING Date GAS PIPING FEE Inspector Inspector LATH &PLASTER PERMIT FEE Date MISC Inspector TOTAL FEE Inspector Data FINAL Date Insoector ELECTRICAL Date Inspector PLUMBING & GAS MAIN DRAIN SERVICE SIZE FEE ,OUTLETS UNITS STORM DRAIN SWITCHES Date Inspector RECEPTACLES WATER SYSTEM SIZE ITERIAL FIXTURES Date Inspector' H.P. CHARGE FIXTURE FEE PERMIT FEE Date Inspector TOTAL FEES Data ROUGH COMPLETE Inspector Date Inspector PLUMBING & GAS MAIN DRAIN SERVICE SIZE FEE UNDERGROUND UNITS STORM DRAIN I SIZE Date Inspector ROUGH WIRING WATER SYSTEM SIZE ITERIAL TOTAL FIXTURES Date Inspector' FINISH WIRING FIXTURE FEE PARTIAL ROUGH Date Inspector FIXTURES Data ROUGH COMPLETE Inspector !STORM DRAIN FEE Date Data MAIN DRAIN Inspector Motors Data, GAS PIPING Inspector GAS PIPING FEE Inspector Date FINAL PERMIT FEE Date MISC Date Inspector PLUMBING & GAS MAIN DRAIN I SIZE FEE MATERIAL UNITS STORM DRAIN I SIZE I LomaTERIAL REGISTERS WATER SYSTEM SIZE ITERIAL TOTAL FIXTURES UNDERGROUND - COMBUSTION VENT FIXTURE FEE PARTIAL ROUGH MAIN DRAIN.FEE MISC Data ROUGH COMPLETE Inspector !STORM DRAIN FEE Data MAIN DRAIN Inspector WATER SYSTEM FEE Data, GAS PIPING Inspector GAS PIPING FEE PERMIT FEE Date FINAL Inspector PERMIT FEE Date MISC Inspector TOTAL FEE Date MISC 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 Date Inspector