NO PERMIT NUMBER (2) Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No.
ry r Sanitary No.
Dote O— 196
--Application is hereby
made for a permit to
Y /1GLG '2llL!'`(.0[i t♦fi r"'v+c'�LtXI/7/�a story, Type
to ben upied only w, �' �� , �A
in accordance wa Plot P an, Plans and Specification filed herewith„
Estimated Value of Improvements $
FEES 0 Plan Check $
Owner V. V9j Address
n IJ�
Contr. 0 Address
Phone State License
Approved
i
p
fA UG 14 1964
APPLICATION FOR ELECTRIC CKMIT
Data -��3 / 196 </ FEE$ I"%ln (^�/
Contr. /�1/�L �LFC//Y,�/ Address •0 f,PQe�l {r
Phone
_-�� �'�Yt7 State License Q it ��/
Approved ��
APPLICATION FOR PLUMBING & GAS PERMIT
Date 196 GAS FEE $
PLUMBING FEE $
Contr. Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEE$
Contr. Address
Phone State License
Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State of California
RECORD OF INSPECTION APPROVALS
FOUNDATION BUILDING
Data Inspector
UNDERFLOOR
Date Inspector
FRAME
Data Inspector
LATH 8 PLASTER
Data Inspector
FINAL
Date I ns oe ctor
ELECTRICAL
.OUTLETS
SERVICE SIZE, fli—
SWITCHES UNDERGROUND
Date Inspector
RECEPTACLES ROUGH WIRING
Data Inspector
FIXTURES FINISH WIRING
/ Date Inspector
H.P. CHARGE Y FIXTURES
Date specter
PERMIT FEE i �% Motors
2 ✓y- Date et r
TOTAL FEES J- `}` FINAL lc,
t�- Date Inspecto
I v4'7l - PLUMBING GAS
MAIN DRAIN SIZE - MATERIAL
STORM DRAIN SIZE f L'tATERIAL
\1J
WATER SYSTEM SIZE I.viATER1AL
TOTAL FIXTURES . UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Date Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Dae! Inspector
STORM DRAIN FEE MAIN DRAIN
Date Inspector
WATER SYSTEM FEE GAS PIPING
Date Inspector
GAS PIPING FEE FINAL
Date Inspector
PERMIT FEE MISC
Date Inspector
TOTAL FEE MISC
Date Inspector
00010
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
} Data _ - _ Inspector