NO PERMIT NUMBER Lot No.
No. Street
i
APPLICATION FOR BU LDING PERMIT
CITY OF CUPERTINO
Sanitary No.7T
/ File No.�3-WAO
Dare J 196� "
Application is hereby made for a permit to
a tory, Type
to be occupied only as
in accordance with Plot Plan, Plans a d Specification filed herewith„
Estimated Value of Improvements $
FEES 7 n Plan Cheek E
Owr,er � Address
Cont,. O Address '2V G
Phone State License al
Approved
61/
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Dare 196 GAS FEE $
PLUMBING FEE $
Contr. -Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEE$
Contr. Address
Phone s 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
DATE INSPECTOR MISC.
PAD FINAL
FOUNDATION
UNDERFLOOR
FRAME
LATH 8 PLASTER
GRADING FINAL
FINAL BLDG.
ELECTRICAL
DATE INSPECTOR MISC.
UNDERGROUND ROUGH
ROUGH WIRING
FINISHED WIRING
FIXTURES
MOTORS
FINAL
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR MISC.
BACK FLOW REO.
SANITARY NO.
UNDERGROUND ROUGH
PARTIAL ROUGH
ROUGH COMPLETE
MAIN DRAIN -I -7I
FINAL PLBG.
FINAL GAS
FINAL APPLIANCE
DATE INSPECTOR MISC.
MISC
MISC
MISC
.17 Bldg. Dept.
Office Copy
BUILDING INSPECTORS OFFICE
jCITY OF CUPERTINO
!Sewer Connection Sanitary Permit No. ---7�(D...1...........
[gf Plumbing Final Plumbing Permit No. .`n0.�
LotNo- -------------------------------
Owner or Tenant .......
At ---:1/'L `i�7....Z`!A -'-- W
Tract
Date Connected -------- '--!�4.... ............... 19............
DateFinal -----------3----I--- - /-----------------------------------------------------n�---o�------,{-}------- 19........---
I ........................ .................
PLUMBING INSPECTOR