NO PERMIT NUMBER (3)Ole e, Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Do to v,.L 196 L
Application is hereby made for a permit to
n a
to be occupied only as
in accordance with plot Plan, Plans
Sanitary No.
.File No.,�
Type
filed herewith„
Estimated Value of Improvements $
7
FEES Plan Check E
Owrmr Address' `
Contr. Address 7
Phone State License oZ ✓ ���
Approved
Date ,
Contr.
Phone
Date
Cont,
Phone
Date
C ontr.
Phone
APPLICATION FOR ELECTRICAL PERMIT
196 FEE$
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
Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State of California .
PAD FINAL
FOUNDATION_
UNDERFLOOR _
FRAME
LATH & PLASTER
GRADING FINAL_
FINAL BLDG. -
UNDEF
ROUGI
FINISH
FIXTU
MOT 01
FINAL
RECORD OF INSPECTION APPROVALS
BUILDING
NSPECTOR MISC.
ELECTRICAL
DATE INSPECTOR MISC.
GROUND ROUGH -
I WIRING
ED WIRING
RES
IS
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR MISC.
BACK FLOW REQ.
SANITARY N0.
UNDERGROUND ROUGH
PARTIAL ROUGH
ROUGH COMPLETE
MAIN DRAIN-
FINAL
RAIN FINAL PLBG. %r
FINAL GAS
FINAL APPLIANCE
DATE INSPECTOR
y
C` Sewer Connection
[Plumbing Final
E
I, Owner or'Tenant
At
Tract �........................
Date Connected
Date Final -----------
Bldg. Dept.
Office Copy
CITY OF CUPERTINO
SEWER -PLUMBING NOTICE -
Sanitary Permit No. ....ja..�f.......
Plumbing Permit No. ....-r3._.��3,(
Lot No .....
19-----------
19 ............
PLUMBING INSPECTOR