NO PERMIT NUMBER (4) 103771 //it.Ki,.J .� (,Q�/� Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO /
File Na.J /d C) L
9 Sanitary No.
Dote / -s 196 —
Application is hereby mnd or a permit to
a ory, Type
to he occupied only as
in accordance with Plot Plan, Plans and Specification filed herewith„
Estimated Valve of Improvements $
FEE$ Plan Check $
n
Ower LQ .i� �� Address
Contr. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEE$
Cont,. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date / 196 7 GAS FEE $
PLUMBING FLEE S •`� r '/
Contr. � - J Address
Phone — 7� G eLO C IState License
Approved 41 /
APPLICATION FOR APPLIANCE PERMIT O
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
Date Inspector
UNDERFLOOR
Date Inspector
FRAME
Date Inspector `
LATH & PLASTER
Date Inspector
FINAL
Date Insoector
ELECTRICAL
,OUTLETS
SERVICE SIZE
SWITCHES UNDERGROUND
Date Inspector
RECEPTACLES ROUGH WIRING
Date Inspector
FIXTURES FINISH WIRING
H.P. CHARGE FIXTURES Date Inspector
Date It
ctor
PERMIT FEE Motors /
Da / ctor
TOTAL FEES FINAL a rod `
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Date Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Do td 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
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
BUILDING DEPARTMENT
I
CITY OF (U PERTINO
Correction Notice
job Located at ......
I have this day inspected this d this structure and these premises
n d h found d the following violations of City and/or State
Ll�ls go eming same
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.......... ..... .. ... ....... .......5-n^- ..... --------------------------------
L-5%--- --- ----I- -- - -------------- —
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You are hereby notified that no more work shal- d e
upon the/sep, ernises until the above violations are corrected.
h - violations
When ccur tons h �,e been ma t e inspector.
0
Date ...... ..
.. ... ...................
-------- .....
Inspector for Building Dept.
THIS
DO NOT REMOVE TI IAG
im 6/63-IM