NO PERMIT NUMBER (3) Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Sanitary No.
File No.
Date 196
Application is hereby made for a permit to
a story, Type
to be occupied only as
in accordance with Plot Plan, Plans and Specification filed herewith,
Estimated Value of Improvements $
FEE$ Plan Check $
Owner Address
Contr, Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date /� 196-7 FEE$
Contr. Address S4—
Ph an.
—Phone -�37a State License �0— Z 2 77,E--�
' Approved
AP PLICATION FOR PLUMBING & GAS PERMIT
Date ie ' 196 71 GAS FEE $
_ / PLUMBING FEE $
Contr, --/�-� Address
Phone Z�[AState License -
c;2- -2 "eJ
Approved C�
v
APPLICATION FOR APPLIANCE PERMIT
Data 196 FEES
Cont,, Address
t'
Phone State License
Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State of California -
b+�+
RECORD OF INSPECTION APPROVALS
BUILDING
DATE INSPECTOR MISC.
PAD FINAL
FOUNDATION
UNDERFLOOR
FRAME
LATH & PLASTER
GRADING FINAL
i
FINAL BLDG.
ELECTRICAL`
DATE INSP E R MISC.
UNDERGROUND ROUGH
]',-'
ROUGH WIRING
FINISHED WIRING
FIXTURES
MOTORS
FINAL
PLUMBING, GAS & APPLIANCE
ATE INSPECTOR MISC.
BACK FLOW REQ.
SANITARY NO.
UNDERGROUND ROUGH
PARTIAL ROUGH
ROUGH COMPLETE ,
MAIN DRAIN
FINAL PLBG. /
FINAL GAS
FINAL APPLIANCE
DATE INSPECTOR MISC.
MISC
MISC
r
MISC
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0 G NO. s'rREET LOT NO.
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CITY OF CUPERTINO
O
3 u my OF cup�nMPLICATION FOR ELECTRICAL PERMIT
I
0 8 1971
LL
„ w D� 19 _ Permit No. �/ Jot ], _
o �
Q Fee s /3 G
a AFpli io is ereby made to the City of Cupertino fora permit to install electrical
wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
o 'o wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
> City of Cupertino, and all other laws applicable thereto.
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