NO PERMIT NUMBER 20659 ' I SHELLY DRIVE Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No. 51084
Sanitary No.
Date _�9-7 196 5
' Application is hereby made for a.permit to
Erect a 1 ' story, Type 5 (10 ' X 15
to be occupied only as Open Patio Cover
in accordance with Plot Plan, Plans and Specification filed herewith,
Estimated Value of Improvements $ -100.00
FEE$ 2 .00 Plan Check $
Owner _ Harvey Nail Address
Contr. Address
Phone 253-2405 State License Homeowner
Approved W. T). Ranevi r.h/hm
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEE$
Contr. Address
Phone kState 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
RECORD OF INSPECTION APPROVALS
FOUNDATION BUILDING
Dote Inspector
UNDERFLOOR
Dote Impactor
FRAME
Dote Ins pectis
LATH 6 PLASTER
`FINAL Inspector
Inanector
ELECTRICAL
0UTI,E ;
SERVICE SIZE
SWITCHES UNDERGROUND
Dote Inspector
RECEPTACLES ROUGH WIRING
Date Inspector
FIXTURES FINISH WIRING
Date Inspector
H.P. CHARGE FIXTURES
Date Inspector
PERMIT FEE Motors
Dote Inspector
TOTAL FEES FINAL
Date Impactor
PLUMBING i GAS
MAIN DRAIN SIZE I I MATERIAL
STORM DRAIN SIZE I LMMTERIAL
WATER SYSTEM SIZE I'TERIAL
TOTAL FIXTURES . UNDERGROUND
,PIXTUR! PER PARTIAL ROUGH
Dote Inspector
MAIN DRAR4 PIRO ROUGH COMPLETE
Data Ms pector
STORM DRAM PEE MAIN DRAIN
Data Impactor
WATER SYSTEM FEE GAS PIPING
Date Inspector
OAS PIPING P E FINAL
Date Inspector
PERMIT FRE MISC
Date Inspector
TOTAL FEE
' ab Inspector
APPLIANCE
TYPE OF APPLIANCE UNITS FEE TYPE OF APPLIANCE UNITS FEE
CIRCULATING HEATERS REGISTERS
BLOWER FURNACES COMBUSTION VENT
j SUSPENDED UNIT MISC
GAS RANGE MISC
GAS DRYER PERMIT FEE
FLOOR FURNACE TOTAL FEE
INSPECTED