FILE 100,053/0 7o14
No.
Lot No.
.00r
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Date '�0��dl 196 J
Application is hereby made for a permit to
to be occupied only as
File No.
Sonitory
a story, Type
in accordance with Plot Plan, Plans and Specification filed herewith,
Estimated Value of Improvements $
FEE$ Plan Check $
Owner Address
Contr. Address
Phone
State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date'/0'/ 196 s
FEE$ J
Contr. ItZ,96,�
Address
Phone a -;`s2
State License
Approved wff�^"�`i
APPLICATION FOR PLUMBING
& GAS PERMIT
Date 196
GAS FEE $
PLUMBING FEE $
Cont,.
Phone
Date
Contr.
Phone
Address
State License
Approved
APPLICATION FOR APPLIANCE PERMIT
196 FEE$
Address
State License
Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State of California
RECORD OF INSPECTION.
APPROVALS
.OUTLETS
FOUNDATION
SWITCHES
BUILDING"
RECEPTACLES'
Date
FIXTURES
ROUGH WIRING
,2
H, P. CHARGE
w
,PERMIT FEE
Date
TOTAL FEES
FINISH WIRING
Inspector'
UNDERFLOOR
PARTIAL ROUGH
D
Ins peetor
FIXTURES
Date
ROUGH COMPLETE
Inspector
Date
FRAME
Inspector
Motors
WATER SYSTEM FEE
Date
GAS PIPING
Date
Spector
FINAL
Inspector
LATH & PLASTER
-PERMIT FEE
-
Date
MISC
Inspector
TOTAL FEE
Inspector
Date
FINAL
Date
Ins oe c for
ELECTRICAL
PLUMBING & GAS
MAIN DRAIN
SERVICE SIZE
.OUTLETS
UNDERGROUND
SWITCHES
STORM DRAIN
RECEPTACLES'
Date
FIXTURES
ROUGH WIRING
,2
H, P. CHARGE
w
,PERMIT FEE
Date
TOTAL FEES
FINISH WIRING
PLUMBING & GAS
MAIN DRAIN
SERVICE SIZE
I
UNDERGROUND
UNITS
STORM DRAIN
I SIZE
Date
Inspector
ROUGH WIRING
WATER SYSTEM SIZE
tATERIAL
TOTAL FIXTURES
Date
Inspector
FINISH WIRING
FIXTURE FEE
PARTIAL ROUGH
D
Ins peetor
FIXTURES
Date
ROUGH COMPLETE
Inspector
STORM DRAIN FEE r
to
Inspector
Motors
WATER SYSTEM FEE
Date
GAS PIPING
e
Spector
FINAL
FINALDate
Inspector
PLUMBING & GAS
MAIN DRAIN
I SIZE
I
I MATERIAL
UNITS
STORM DRAIN
I SIZE
I
ATERIAL
REGISTERS "
WATER SYSTEM SIZE
tATERIAL
TOTAL FIXTURES
UNDERGROUND
COMBUSTION VENT
FIXTURE FEE
PARTIAL ROUGH
MAIN DRAIN FEE
MISC
Date
ROUGH COMPLETE
Inspector
STORM DRAIN FEE r
Date
MAIN DRAIN
Inspector
WATER SYSTEM FEE
Date
GAS PIPING
Inspector
GAS PIPING FEE
PERMIT FEE
FINALDate
Inspector
-PERMIT FEE
-
Date
MISC
Inspector
TOTAL FEE
Dote
MISC
Inspector
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
Data
Inspector