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