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512262ZS No. Street Z„ C7— Lot No, APPLICATION FOR BUILDING PERMIT CITY OF CUPERTINO Sanitary No.� _ File No.®S 'yY(. Date 196_ A kation is her by made for ¢permit to �a _zbit —a story, Type to be occupied only as ( l ' in accordance with Plot Plan, Plans and Specification filed herewith, Estimated Value of Improvements $ 2I �� FEE$ (.16t1b Plan Check Owner AddressC Contr. _ �/IN...y.A Address _ I did% — n 6( L .-6 .S-0 Phone y State Licem Approved APPLICATION FOR ELECTRICAL PERMIT Date �-(,3 196_ / I FEE$ -1,32-0 %�� Contr. �W2(� O/� ��.i� Address /174lw n / 12A S� Phone 36-D-7yc> State License 20U oOn Approved APPLICATION FOR PLUMBING & GAS PERMIT Date 196 7/ GAS FEE $ (/s.) � yp�/ PLUMBING FEE $ o2ef, S� Contr. a'�-+--A'�Address 011-y l'=% Phone& %8 - � 9 � State License Approved i l' C APPLICTION FOR APPLIANCE PERMIT { 7 zs Date ((JJ �� ��1% FEE$ �A Contr. i���A R�p i 2?uw Cl Address 0—�•�`� $tote Licensee"rte Approved Applicants agree not to violate any of the. Workman's Compensation Laws of the State of California RECORD OF INSPECTION APPROVALS UNDERGROUND ROUGH ROUGH WIRING FINISHED WIRING FIXTURES MOTORS BACK FLOW REQ. SANITARY NO. UNDERGROUND ROUGH— PARTIAL ROUGH ROUGH COMPLETE MAIN DRAIN 3-3-7 FINAL PLBG.�;-20 - FINAL GAS -2 7p-71/ FINAL APPLIANCE S - BUILDING INSPECTO ELECTRICAL DATE lNSPECfbR t O - rJ PLUMBING, GAS & APPLIANCE DATE INSPECTOR DATE -3-/15-7, MISC. • i I , DATE PAD FINAL FOUNDATION UNDERFLOOR '! FRAME - LATH & PLASTER GRADING FINAL FINAL BLDG. UNDERGROUND ROUGH ROUGH WIRING FINISHED WIRING FIXTURES MOTORS BACK FLOW REQ. SANITARY NO. UNDERGROUND ROUGH— PARTIAL ROUGH ROUGH COMPLETE MAIN DRAIN 3-3-7 FINAL PLBG.�;-20 - FINAL GAS -2 7p-71/ FINAL APPLIANCE S - BUILDING INSPECTO ELECTRICAL DATE lNSPECfbR t O - rJ PLUMBING, GAS & APPLIANCE DATE INSPECTOR DATE -3-/15-7, MISC. • i I , CERTIFICATE OF COMPLETION BUILDING INSPECTOR'S OFFICE CITY OF CUPERTINO Date ...............97.ung . The Building Lmk,4,.t .... Owned by ...... -------------------------------------------------- % ..................... Has Been -C Use As: ..... ............ CL or W