51037 --------------
Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No. /O 3
Sanitary No.
Date 7'�,�196
Application is hereby made for a permit to
— a story, Type '* A/ '
to be occupied only as
in accordance with plot Plan, Plans and Specificatior led herewith.
Estimated Value of Improvements § toC
FEE§ Plan Check §
Owner ) Address
Cont,. Address
Phone go-2-9- State License/
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Data .196 - GAS FEE §
PLUMBING FEE $
Cont'. 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
Date Inspector
,UNDERFLOOR
Date Inspector
FRAME
Do to 1 ns pe ctor
LATH 8 PLASTER
Date Inspector
FINAL
Dote I ns De ctar
ELECTRICAL
,OUTLETS SERVICE SIZE
SWITCHES UNDERGROUND
RECEPTACLES ROUGH WIRING Date Inspector
FIXTURES FINISH WIRING Dote Inspector
H.P, CHARGE FIXTURES Date Inspector
Date Inspector
PERMIT FEE Motors
TOTAL FEES FINAL Date Inspector
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE I I MATERIAL
STORM DRAIN I SIZE I Lw6TERIAL
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Dote Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Data Inspector
STORM DRAIN FEE MAIN DRAIN
Data 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
CITYNoENO
Street /3 7
WAicR DEPT
. Lot No.
CITY OF CUPERTINO
1971 APPLICATION FOR BUILDING PERMIT
Sanitary No.
p0VA R ® ' 19 _ Pen No. s / G37
Y0 Application is hereby made for permit to
'c PP Y
`0 4
3 U a ,TYP Building
v
w to be occupied only s in accordance with
o P.' Plans,Specifications and lot-Plan filed herewith. PI Ck Fee
T ma
ro 8stimatod Value of Improvements,$ goZ
Q� �"' Fee$ i'
d
0 o It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
'> all other laws applicable to the construction, location, and use of buildings within the City of
c Cupertino will be complied with. Y
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oPhoneZ 0? yj Approv
U State License 0 II J!'" RoUdiWinspector
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