NO PERMIT NUMBER (2) rl
Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Sanitary No. / (a 3
File No.J-/
Date , G 196 ��
Application is hereby made for a permit to
a story, Type
to be occupied only as
in a.cordance with Plot Plan, Plans and 115a
cification filed herewith,
Estimated Value of Improvements $
FEE$
Plan Chock $
Owner Address '
Contr. _L�.�p!L Address
Phone 3 7 0 Z�/ Q
State License Z Z d 7 J f,
e
Approved �
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Data 196 GAS FEE $
PLUMBING FEE $
Contr. Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEES
Contr. Address
Phone State License
Approved
Applicants agree not to violate any of the
Workmnn's Compensation Laws of the
State of California
RECORD OF INSPECTION APPROVALS
BUILDING
DATE INSPECTOR MISC.
PAD FINAL
FOUNDATION
UNDERFLOOR
FRAME
LATH & PLASTER
GRADING FINAL
FINAL BLDG.
ELECTRICAL
DATE INSPECTOR MISC.
UNDERGROUND ROUGH
ROUGH WIRING
FINISHED WIRING
FIXTURES
MOTORS
FINAL
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR MISC.
BACK FLOW REq.
SANITARY N0.
UNDERGROUND ROUGH
PARTIAL ROUGH
ROUGH COMPLETE
MAIN DRAIN `/ "��-�
FINAL PLBG.
FINAL GAS
FINAL APPLIANCE
DATE INSPECTOR MISC.
MISC
MISC
1
MISC
No. Street Lot No.
o — §
P TION FOR PLUMBING PERMIT
E ® (.CITY OF CUPERTINO
111 lJAN 1.3 1969
Sanitary No. _
G 4 .3 /3,=
EU 96_ Permit No..�/
0
4.E i 1 CUPERTM
3 Fee $
r Application is hereby made to the City of Cupertino for a permit to install plumbing pipes
and/or fixtures listed on the reverse side hereof,and agrees to install said prices and/or fixtures
A in accordance with the provisions of the Plumbing Code of the City of Cupertino,and all other
A laws applicable thereto.
0
0
U 0 Use of Premises
o y Owner .�Tg �,�5/ L./ o,�/gr[:.S Address:Zaa G -�l//t' eY2�
.3 d ByyLCpr Address/}?/!"/y
^ Con ractor,Agent
v_ 7
Phone.
m �
^ ^a State Licensel 'Z'7 A
pproved
Plumbing Inspector ��
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