51006 0 I (/ Lot No.
No. Street "
APPLICATION FOR BUILDING' PERMIT
CITY OF CUPERTINO
File No. S"10 a
Sanitary No.
Date a � S 196 "'�
pplication is hereby ode for a Uermit to
story, Type
to be occupied only as
in accordance with Plot Plan, Plans and Specification filed herewith.
Estimated Value of Improvements $
FEE$ Pion Check $
Owner Address
Conti, Address
Phone' - State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Data 196 FEE$
Contr. Address
Phone State License
'Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Dote ` -$ 196 GAS FEE $ _
PLUMBING FEF t 4e—r
Contr. Address
Phone .2- 2 3- 0 z7- State License
Approved w�
APPLICATION FOR APPLIANCE PERMIT
Date 1% FEE$
Contr. Address
Phone ';S ate 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 in pe etor-•
UNDERFLOOR
Date .# Inspector''
FRAME "
Date Inspector
LATH & PLASTER I
FINAL Date Inspector
to Ins oector
ELECTRICAL "
,OUTLETS' '
I SERVICE SIZE
SWITCHES UNDERGROUND —�_
Date Inspector
RECEPTACLES ROUGH WIRING
FIXTURES FINISH WIRING Dote Inspector
.M.P. CHARGE FIXTURESDate Inspector
-
Date - Inspector
PERMIT FEE Motors II`
Ins pector
TOTAL FEES FINAL " Date
Data Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE I .MATERIAL
i
I
i
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES y UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Date 'Inspector
MAIN DRAIN FEE .. ROUGH COMP ETE
Date" spector
STORM DRAIN FEE MAIN RAI
Date pector .
WATER SYSTEM FEE i'T' S I G A "
'Date pector
GAS PIPING FEE I AL
�I Date I Inspe for
PERMIT FEE °+' ISC
11 Date Inspector
TOTAL FEE ' ISC
Date Inspector
APPLIANCE
TYPE.OF APPLIANCE UNITS IFEE TYPE OF APPLIANCE UNITS FEE
CIRCULATING HEATERS REGISTERS
BLOWER FURNACES iCOMBUSTION-VENT -
SUSPENDED UNIT MISC
GAS RANGE MISC
GAS DRYER' 3
I�_ PERMIT FEE'
FLOOR FURNACE �i TOTAL FEE -
INSPECTED
Do to Inspector
o04
OT NO.
E
® APP ICN FOR PLUMBING PERMIT
" a ITY OF CUPERTINO
w /AUt; 15 1966
x o Sanitary iA'o.
O4 / /Ooh
3 C� 1 1 1960 Permit No
I � RT
w LL INO Fee $�
= n
Application is hereby made to the City of Cupertino for a permit to install plumbing
'o r pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
> a
and/or fixtures in 6cLordincc with the provisions of the Plumbing Code of the City of
a w Cupertino, and l utt laws appIt e veto.
w S O
� r
a Use of Premises
J
O 0 O O
> N /dao '
o a O r A ess d
z J U
z Address
O
3 F ONTRA O , AGENT
— w Ph 17,9
a
f 'tate Licen � ApprovedwN
PLUMBING INSPECTOR ` 1/
FIXTURES
UNITS FEES UNITS FEES
Water Hcate Size
Water Closets Material
Bath Tubs To Curb
Showers To Prop. Line
Lavatories To Existing
Kitchen Sinks Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
\Y/as-Trays STORM DRAINAGE
Washing Machines Size
Water Softeners Material
Bar Sinks To Main Drain
Com . Sinks Trays To Curb
Dental Units
Drinking Fountains
Floor Drains WATER SYSTEM
Hoppers Size
Restaurant Sinks Material
San Traps TOTAL FEES
Urinals Fixture Fee /, 00
Area Drains Main Drain Fee
Nater Leaders Storm Drain Fee
Sprinkler Valves Water Sys. Fee /,00
Permit Fee •G O
TOTAL TOTAL FEE p d
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final