File 51129/i 75e?l xllor�� Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO i
/ File No.
1 10itskitary No.
Date 196 1
Appli tion is rc made
to 6e occupied only a. _
story, Type
accordance witA Plot Plan, Plans and Specification filed herewith.
Estimated Volee of Improvements
FEE$n
Ower. l — • t /�1
Contr.
Phone
§
Plan Check $
Address
Address
State License
Approved _
APPLICATION FOR ELECTRICAL PERMIT
Data 196 FEES
- C ontr
Address
Phone State License
Approved -
At� M AOMION16pp6R PING & GAS PERMIT
DareCIT l GAS FEE $
- D. wl PLUMBING FEE c s
Cootr. �/. /��/�J/`]�`"� Address A�
Phone rT/ J - 3 r 3 !^ Stare License / Z 3 T a 3
IJ- Approved
Do to
Cont,
Phone
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
Inspector
FOUNDATION
Inspector
BUILDING
SWITCHES
Date
Date
RECEPTACLES
Inspector
Inspector
UNDERFLOOR
WATER SYSTEM
H.P. CHARGE
11TERIAL
Inspector
Date _
FRAME'
TOTAL FEES
UNDERGROUND
'
GAS RANGE
FIXTURE FEE
Dote
MISC
PARTIAL ROUGH
Inspector
LATH & PLASTER
MAIN DRAIN FEE
PERMIT FEE
ROUGH COMPLETE
Date
Inspector
Date
FINAL
MAIN DRAIN
Do to
Inspector
WATER SYSTEM FEE
do �
GAS PIPING
Date
Date
GAS PIPING FEE
Ins Dector
Data
FINAL _ d2rTp. _.15_
ELECTRICAL
PERMIT FEE
UNDERGROUND
ROUGH WIRING,
FINISH WIRING _
FIXTURES
Motors
FINAL
SERVICE SIZE
Date
Inspector
,OUTLETS
Inspector
Date
SWITCHES
Date
Inspector
RECEPTACLES
Inspector
FIXTURES
WATER SYSTEM
H.P. CHARGE
11TERIAL
PERMIT FEE
TOTAL FIXTURES
TOTAL FEES
UNDERGROUND
'
UNDERGROUND
ROUGH WIRING,
FINISH WIRING _
FIXTURES
Motors
FINAL
SERVICE SIZE
Date
Inspector
Date
Inspector
Date
Inspector
Date
Inspector
Dote
Inspector
Date Inspector
PLUMBING & GAS
MAIN DRAIN
SIZE
I
I MATERIAL
UNITS
FEE
CIRCULATING HEATERS
STORM DRAIN
SIZE
I
LOMTERIAL
BLOWER FURNACES
WATER SYSTEM
SIZE
11TERIAL
SUSPENDED UNIT
TOTAL FIXTURES
MISC
UNDERGROUND
'
GAS RANGE
FIXTURE FEE
MISC
PARTIAL ROUGH
GAS DRYER
MAIN DRAIN FEE
PERMIT FEE
ROUGH COMPLETE
Date
Inspector
STORM DRAIN FEE
TOTAL FEE
MAIN DRAIN
Do to
Inspector
WATER SYSTEM FEE
do �
GAS PIPING
Date
Inspector
GAS PIPING FEE
Data
FINAL _ d2rTp. _.15_
I p
PERMIT FEE
MISC
Date
spector
TOTAL FEE �
/I
MISC
Date
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
Date Inspector