NO PERMIT NUMBER (2)Lot No.
,APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Sanitary No.
File No.��
Date 196-7--
Application is hereby made for a permit to
a story, Type
In he occupied only as 1;oF_ '*
in accoraKnce,with plot Plan, Pians and SpIcification filed herewith,
Estimated Value of Improvements $
FEES �7 Pt Plan Check $
Owner / �� AdTTA a.o Address
Cant, Address
Phone 0 State License
Approved
Date
Contr,
Phone
Do to
Contr.
Phone
Data
Contr,
Phone
APPLICATION FOR ELECTRICAL PERMIT
196 FEES
Address
State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
196 GAS FEE $
PLUMBING FEE $
Address
State License
Approved
APPLICATION FOR APPLIANCE PERMIT
196 FEES
Address
State License
,i Approved
Applicants agree not to biolate any of the
Workman's Compensation Laws of the
State of California ,
PAD FINAL,
FOUNDATION
UNDERFLOOR
FRAME
LATH & PLASTER
GRADING FINAL
FINAL BLDG.
UND
ROU
FINI
FIX'
MOT
FIN,
RECORD OF I+!SPECTION APPROVALS
BUILDING
INSPECTOR MISC.
ELECTRICAL
DATE INSPECTOR MISC.
?RGROUND ROUGH -
.H WIRING
iHED WIRING
'URES
ORS
�L
BACK FLOW REQ._
SANITARY NO. _
UNDERGROUND RO
PARTIAL ROUGH _
ROUGH COMPLETE
MAIN DRAIN
FINAL PLBG. _^_,A
FINAL GAS
FINAL APPLIANCE
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR MISC.
INCPF(7np
MISC.
Bldg. Dept.
Office Copy
CITY OF CUPERTINO
SEWER -PLUMBING NOTICE
❑ Sewer Connection
Sanitary
Permit
No. _4472/9-- --- ---
Plumbing Final
Plumbing
Permit
No,-s.��,�
Lot No. ..... - - ...
Owner or Tenant
At
c
Tract
Ah�L/NW OR LOT
O. MEEI'
z Q
wZ
AP CN FOR PLUMBING PERMIT
®I fri F CIJPGRTINO
Sanitary No.
Date '11Permit No._��9
Pee $
pipesPAppl�4irty isprTb Pp�pyhq of Cupertino for a Permit to install plumbing
i es and'oriifx r s h f 11 •t1 se side hereof, and agrees to Install said prices
and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
Cuper ;.._ __. I .. .
Use of
Owner
By—«l�� �'� / Q 'tel �� Address
CONTRACT ORAGENT
Phone -,—) 5Z — Gig %7
State License Approve
PLIJM8ING INSPECTOR
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