NO PERMIT NUMBER (2) colo (0 Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No. !i!77�� 3n
E? Sanitary No. ��
Dore 196 E
Application is hereby made for a permit to
a story, Type
to be occupied only as
in ccordance with Plot Pian, Plan and Specification filed herewith.
Estimated Valae of Improvements $
FEES Plan Check $
Owner Address
Contr. / Address Y- Vre-r
Phone �94 - 3�/FL State License 7"lyc0
Approved KXZ
KL
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date 196 GAS FEE $
PLUMBING FEE $
1 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
Workman's Compensation Laws of the
State of California
i
RECORD OF INSPECTION APPROVALS 1•
FOUNDATION BUILDING
Date Inspector
UNDERFLOOR
Date Inspector
FRAME
Date Ins pe c tar
LATH 8 PLASTER
Date Inspector
FINAL
Date Ins oe c for
ELECTRICAL
OUTLETS
SERVICE SIZE
SWITCHES. UNDERGROUND
Date Inspector
RECEPTACLES ROUGH WIRING
Date Inspector
FIXTURES FINISH WIRING
M,P, CHARGE FIXTURES Date Inspector
Date Inspector
PERMIT FEE Motors
Date Inspectar
TOTAL FEES FINAL
Do to Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
WATER SYSTEM SIZE1-- TERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Date Inspector
MAIN DRAIN FEE ROUGH COMPLETE
D or
STORM DRAIN FEE MAIN DRAIN S
Date Inspector
WATER SYSTEM FEE GAS PIPING
Data or
GAS PIPING FEE FINAL '�
PERMIT FEE
Dote Inspecto
TOTAL FEE MISC
' Date 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
Bldg. Rept.
--office-copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
Ej Sewer Connection Sanitary Permit No. .....410-04-371
g-�PlUMin Final Plumbing Permit No. -- -----
,
Z14
--46, Lot No. ................ .....
Owner or Tenant ...
At
Tract ................
DateConnected ---------------------------- —------*------------------------ -- ------------- - 19
Date Final X— —---------------------------
.. .............................. 1945�k-
---------- - -------
PLUMBING INSPECTOR
111 12/66-IM