51139 y
c:-206-741 � gAtj.e Lott No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No.
Sanitary No.
Date � � 196
A U ation.ie-4nreby mn for a permit to
4�2Y. Type
to be occupied only as
in accordance with Plot Plan, Plans and Specification filed herewith,
Estimated Value of Improvements $
FEES n /f Plan Check $
Ovirmr �. ?-A 12 &:6: 4. Address
Contr. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Dote k?119 196 �- GAS FEE $
PLUMBING FEE $
Contr. Address 30M 45
Phone — ��� �t�Cd State License 7��7
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
BUILDING
FOUNDATION
Date Inspector.
UNDERFLOOR
Date Inspector
FRAME
Date Inspector
LATH & PLASTER '.
Date Inspector
FINAL
Data Insoector
ELECTRICAL
,OUTLETS SERVICE SIZE
SWITCHES UNDERGROUND
Date Inspector
RECEPTACLES ROUGH WIRING
Do to Inspector
FIXTURES FINISH WIRING
Date Inspector
M.P. CHARGE FIXTURES
Date Inspector
PERMIT FEE Motors
Date Inspector
TOTAL FEES FINAL
Dote 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
Date Inspector
STORM DRAIN FEE MAIN DRAIN
Date Inspector
WATER SYSTEM FEE GAS PIPING
Date or
GAS PIPING FEE FINAL
Date Inspector
PERMIT FEE � MISC
Date Inspector
TOTAL FEE
Joe 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
nate Ins pe c tar
LOT NO.
T EET
2A IA
eP ION FOR PLUMBING PERMIT
z CITY OF CUPERTINO
r o
V SEF �. 9 x966 Sanitary No.
0
0 Date—Sept. 16- 196-6 Permit No ..-5-/14;;f
a
oCITY OF CUPERTINO Pee §
Application is hereby made to the City of Cupertino for a permit to install plumbing
o a pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
i I and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other laws applicable thereto.
"x
j n Use of Premises 20573 Rodriquez
00
' "
O 3 Owner C. F. McCarthy Address same
O<
ZJ
o By Cull Address 380 E. Evelyn
3 r C NTRACTOR, AGENT
-< Phone 736-2000
wz
<o State License 217597 Approved & '
U I� PLUMBING INSPECTOR
FEES
Water Heate
ns
Valves
Boxes
""^f- I j.UUll IUTAL I'LL ,:J— C2 0
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
.scam "rain
Final