NO PERMIT NUMBER .20'j Lot No.
No. styt
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No. fir/
Sanitary No.
Do to / e 196
Application is hereby made for a permit to
- �1 / story, Type
to be occupied only as �t. o
in acclVdanee with Plot Plan, Plans and Specification filed herewith,
d e
Estimated Value of Improvements S 'go a
FEES °�� Plan Check S
Ownar �, Address
Contr. '�`�✓ Address
Phone JF' 8'/ 810 0 State Licens
Approved
v ..09 .
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
Contr. Address
Phone State 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
Date Inspector
UNDERFLOOR
Dote Inspector
FRAME
/ Date Inspector
LATH IS PLAS R
^ Date n or
FI AL
Date Ins ae ctor
ELECTRICAL
,OUTLETS SERVICE SIZE
SWITCHES. UNDERGROUND
Date Inspector
RECEPTACLES ROUGH WIRING
Date Inspector
FIXTURES FINISH WIRING
Date Inspector
M.P. CHARGE FIXTURES
' Dote Inspector
PERMIT FEE Motors
Date Inspector
TOTAL FEES FINAL
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Date Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Date Inspector
STORM DRAIN FEE MAIN DRAIN
Data Inspector
WATER SYSTEM FEE GAS PIPING
Dote Inspector
GAS PIPING FEE FINAL
Date Inspector
PERMIT FEE MISC
ate Inspector
TOTAL FEE MISC
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 FEES '
FLOOR FURNACE TOTAL FEE
INSPECTED
Date Inspector
2D36 Q I CL /FEwJ �claY LOT No.
NO. STREET
Crry of APPLICATION FOR APPLIANCE PERMIT
d z MAR 11971 CITY OF CUPERTINO
I K
Y LL
3DRe A 4- D „ 197/- Permit No.
U
�(
LL
Fee,$
' 0 Application is hereby m8tle to the City of Cupertino for a permit to
o install gas appliances as listed on the reverse side hereof, and agrees to
ia install said appliances in accordance with the provisions of the Plumbing
Code of the City of Cupertino, and all ther 1 ws apIlicable thereto.
Use of Premises /WE S,/Zy) j cce�
Oc
> m
O3 /� PhOwner l 0Cj_� wj Address 2o364..CL/F1x`y 6j/
o < nn �
� = By V19L[Fi TIAI-C Address :52�0 /iE✓Td-JrJ?. rS C.
J'O CONTRACTOR,AGENT
a
Phone. 2i�& 63
oIr State License �ZO76-Se Approved 93a1
PCllMan7G INSPECTOR
3 c No
O _ -
c n
;' 3 _ r.• o � � o co - f es tea
1
o � C
- Z
n � y
N
y
4��� ■ cLAW W-� C /�T LOT NO.
O
, STREET
N FOR BUILDING PERMIT
Im; ° ® Erb1 OF CUPF.RTINO
Or " ��j1
o a Sanitary No.
I,
Uate �(0 5 166 196_ Permit No. y��.�e
ro
i
Application
isherebD m d a permit
° CT�Of T�I /J iP�c
Building
r to be occupied only as S/ in accordance with
0 o Plans, Specifications and PI t-Plan led herewith. PI Ck Fee
Estimated Value of Improvements, B® Fee$ 3 cu
o <
z J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
J z all other laws applicable to the construction, location, and use of buildings within the City of
a Cupertino will be complied with.
OwnerCOA/00 /� Address2m361 Ck �DE1J wn�
WW Byt ny n:wr Address;'Z'7"I6 At-1c6 A t M. L p
02
< 0 Phon� gE leo dd Approved
State Livens - euun INSPECTOR