51043.1-C220975 I VALLEY GREEN DRIVE LotNo.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Date 196
Application is hereby made for a permit to
a
to he occupied only as
FEE$
Owner
Contr.
Phone
File No. 51043.1
Sanitary No.
story, Type
in accordance with Plot Plan, Plans and Specification filed herewith,
Estimated Value of Improvements
$
Plan Check $
Address
Address
State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEE$
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date 196 GAS FEE $ —
I Contr.
Phone
Data
Contr.
Phone
PLUMBING FEE $
Address
State License
Approved
APPLICATION FOR APPLIANCE PERMIT
196 FEES
Address
State License
Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State of California
RECORD 0� IfISPECTIQN APPROV
UNDERFLOOR
Date
TERIAL
Inspector
FRAME I'
eu , (.(z
TE
SWITCHES
Inspector
LATH &PLASTER
Date
Do to
Inspector
FINAL
Date
Date
Inspector
Date
Date
Insoector
ELECTRICAL
SERVICE SIZE
UNDERGROUND
SIZE
TERIAL
,OUTLETS
Data
Inspector
SWITCHES
FIXTURE FEE
RECEPTACLES
Do to
Inspector
FIXTURES
Date
Inspector
Date
Inspector
rH.P.ARGE
FEE
FEES
Date
Inspector
ELECTRICAL
SERVICE SIZE
UNDERGROUND
SIZE
TERIAL
TYPE OF APPLIANCE
Data
Inspector
ROUGH WIRING
FIXTURE FEE
REGISTERS
Do to
Inspector
FINISH WIRING
Date
Inspector
Date
Inspector
FIXTURES
MISC
Date
Inspector
Motors
MAIN DRAIN
MISC
Date
Inspector
FINAL
Inspector
WATER SYSTEM FEE
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE 1 r MATERIAL
STORM DRAIN I SIZE I I MATERIAL
WATER SYSTEM
SIZE
TERIAL
TYPE OF APPLIANCE
TOTAL FIXTURES
FEE
UNDERGROUND
FIXTURE FEE
REGISTERS
PARTIAL ROUGH
BLOWER FURNACES
Date
Inspector
MAIN DRAIN FEE
ROUGH COMPLETE
MISC
Data
Inspector
STORM DRAIN FEE
MAIN DRAIN
MISC
Date
Inspector
WATER SYSTEM FEE
PERMIT FEE
GAS PIPING
FLOOR FURNACE
Date
Inspector
GAS PIPING FEE
FINAL
Date
Inspector
PERMIT FEE
MISC
Date
Inspector
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