51043.1 (8)I No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Lot No.
File No. S/o K'S
9 /
Son itary
Dore 796
A icailors is hereby de for ¢ permit to
a story
to be o .¢pier ly as
Type
in accordance with Plot Plan, Plans and Specification filed herewith,
Estimated Value of Improvements $
FEES / n Plan Check $
Owner Address
Contr,
I Phone
Address
State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEE$
Contr. Address
1 Phone State License
Approved
APPLICATION FOR ,PLUMBING 8 GAS PERMIT
Data 1966 GAS FEE $
PLUMBING FEE x /) /�
cont'. /ti�R/l.iw�rCiE..O..J C.�-A-
Phone —� ` �0 �s State License Z 'r7 /V 10G
Approved `�4+�e.F��T •—�i�-1..�
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
RECORD OF INSPECTION APPROVALS
FOUNDATION
SIZE
BUILDING
,OUTLETS
Date
Inspector
SWITCHES
UNDERGROUND
RECEPTACLES
Date
Inspector
FIXTURES
Inspector
UNDERFLOOR
H.P. CHARGE
Date
Inspector
-
ROUGH COMPLETE
Inspector
Date
FRAME
Inspector
Motors
STORM DRAIN FEE
MAIN DRAIN
Date
Inspector
FINAL
Date
Inspector
Date
GAS PIPING
Inspector
LATH & PLASTER
TOTAL FEE
Date
Inspector
—
FINAL
Dyfe
C
�
�jns pe ctor
Date
Date
PERMIT FEE
Insoector
MISC
ELECTRICAL
SERVICE SIZE
UNDERGROUND
SIZE
FEE
,OUTLETS
Date
Inspector
SWITCHES
UNDERGROUND
RECEPTACLES
Date
Inspector
FIXTURES
H.P. CHARGE
Date
Inspector
PERMIT FEE
ROUGH COMPLETE
TOTAL FEES
Date
Inspector
SERVICE SIZE
UNDERGROUND
SIZE
FEE
TERIAL
Date
Inspector
ROUGH WIRING
UNDERGROUND
FIXTURE FEE
Date
Inspector
FINISH WIRING
Date
Date
Inspector
FIXTURES
ROUGH COMPLETE
MISC
Date
Inspector
Motors
STORM DRAIN FEE
MAIN DRAIN
Date
Inspector
FINAL
Date
Inspector
Date Inspector
PLUMBING & GAS
' MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
WATER SYSTEM
SIZE
FEE
TERIAL
UNITS
TOTAL FIXTURES
CIRCULATING HEATERS
UNDERGROUND
FIXTURE FEE
PARTIAL ROUGH
BLOWER FURNACES
Date
Inspector
MAIN DRAIN FEE
SUSPENDED UNIT
ROUGH COMPLETE
MISC
Data
Inspector
STORM DRAIN FEE
MAIN DRAIN
GAS DRYER
Date
Inspector
WATER SYSTEM FEE
GAS PIPING
TOTAL FEE
Date
Inspector
GAS PIPING FEE
FINAL
1/
Date
Inspector
PERMIT FEE
MISC
Inspector
TOTAL FEE
9Date
MISC
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