NO PERMIT NUMBER -20 17 $1 Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO syr
File No0aa 0
Sanitary No.
Date 196
4pplication is hereby made for a permit to
a story, Type
to be cupied only as
in accordance with Plot Plan, Plans and Specification filed herewith,
Estimated Value of Improvements $ J �Q
fI0
FEES _ r. Plan Check $
Owner /K /
�/f Address
Contr.
Address
Q L
Phone *2 G 14_ / �• State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Data 196 FEES
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date 196 GAS FEE $
PLUMBING FEE $
Contr. Address
Phone - State License
Approved
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
PAD FINAL
GRADING FINAL
RECORD OF INSPECTION APPROVALS
FOUNDATION BUILDING
Date Inspector
UNDERFLOOR
Date Inspector
FRAME
Do to Inspector
LATH & PLASTER
Data Inspector
FINAL
Date Ins De ctar
ELECTRICAL
,OUTLETS
SERVICE SIZE
SWITCHES UNDERGROUND
Date Inspector
RECEPTACLES ROUGH WIRING
Date Inspector
FIXTURES FINISH WIRING
Date Inspector
H.P. CHARGE FIXTURES
Date Inspector
PERMIT FEE Motors
Date Inspector
TOTAL FEES FINAL
Dote Inspector
PLUMBING & GAS
MAIN DRAIN SIZE I I MATERIAL
STORM DRAIN I SIZE I 191wTERIAL
I
WATER SYSTEM SIZE ITR
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Date Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Date Inspector
STORM DRAIN FEF: MAIN DRAIN
Date Inspector
WATER SYSTEM FEE GAS PIPING
/Dote r
[PERMIT
AS PIPING FEE FINAL
Date Inspector
FEE MISC
Date ns pec for
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
n„t. Ins Doctor
cdVDO7`J� lr2 '. a LOT NO.
NO, sTRCRT
APPLICATION FOR"P,LUMBING PERMIT
,I C:ITrY&L CUPERTIIVOz :i � I
x o 1 mitar No.
2 3 I FFp>a 19th :",
0 , 1):Ire(�� 19(a Pennit'No
3u p p C
i o „I,-•,� t7 _b� _\t(1Pcc syr
Application is hereby made,tp�Ihc Crty nflSsupertin f�r a,permit to install plumbing
o a Pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
i m and/or fixtures in_ac�oordance with the provisions of the Plumbing Code of the City of
a W Cupertino, and rll other laws iI it le thereto.
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—U PLUMBING INSPECTOR
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