51039/002 !zo
No.
Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Data 196
Application is hereby made for a permit to
a
to be occupied only as
Lot No. /D
File No. '�r/O
Sanitary No.
story, Type
in accordance with Plot plan, Plans and Specification filed herewith,
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Data 196 GAS FEE $ —
PLUMBING FEE $
Contr.
Phone
Date
Contr.
Phone
Address
State License
Approved
APPLICATION FOR APPLIANCE PERMIT
196 FEES
Address
State License
Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State of California
Estimated Value of Improvements $ —
FEES
Plan Check E
Owner _A&4^4
K
Address
Cerrtr•
Address
Phone
State License
Approved _
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Data 196 GAS FEE $ —
PLUMBING FEE $
Contr.
Phone
Date
Contr.
Phone
Address
State License
Approved
APPLICATION FOR APPLIANCE PERMIT
196 FEES
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
I MATERIAL
FOUNDATION
Date
BUILDING
SWITCHES
UNDERGROUND
RECEPTACLES
Date
Inspector
FIXTURES
Date
H.P. CHARGE
Inspector
UNDERFLOOR
PERMIT FEE
ROUGH COMPLETE
TOTAL FEES
Date
Inspector
Date
FRAME
MAIN DRAIN
Date
Inspector
FINAL
Date
Inspector
WATER SYSTEM FEE
Inspector
LATH 8 PLASTER
TOTAL FEE
Date
Inspector
Inspector
Date
FINAL
Date
FINAL
PERMIT FEE
MISC
Data
Ins as c tar
Inspector
TOTAL FEE
ELECTRICAL
MISC
SERVICE SIZE
UNDERGROUND
SIZE
I MATERIAL
OUTLETS
Date
Inspector
SWITCHES
UNDERGROUND
RECEPTACLES
Date
Inspector
FIXTURES
H.P. CHARGE
Date
Inspector
PERMIT FEE
ROUGH COMPLETE
TOTAL FEES
Date
.Inspector
SERVICE SIZE
UNDERGROUND
SIZE
I MATERIAL
TERIAL
Date
Inspector
ROUGH WIRING
UNDERGROUND
FIXTURE FEE
Date
Inspector
FINISH WIRING
Date
Date
Inspector
FIXTURES
ROUGH COMPLETE
MISC
Date
.Inspector
Motors
STORM DRAIN FEE
MAIN DRAIN
Date
Inspector
FINAL
Date
Inspector
Date Inspector
PLUMBING & GAS
MAIN DRAIN
SIZE
I MATERIAL
TERIAL
STORM DRAIN
SIZE
i6wTERIAL
UNDERGROUND
SYSTEM
SIZE
IQFWATER
TERIAL
UNITS
TOTAL FIXTURES
CIRCULATING HEATERS
UNDERGROUND
FIXTURE FEE
PARTIAL ROUGH
BLOWER FURNACES
Date
Inspector
MAIN DRAIN FEE
SUSPENDED UNIT
ROUGH COMPLETE
MISC
Data
Inspector
STORM DRAIN FEE
MAIN DRAIN
GAS DRYER
Date
Inspector
WATER SYSTEM FEE
GAS PIPING
TOTAL FEE
Date
Inspector
GAS PIPING FEE
FINAL
Date
Inspector
PERMIT FEE
MISC
Date
Inspector
TOTAL FEE
MISC
APPLIANCE
TYPE OF APPLIANCE
UNITS I
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
No. Street
Lo[ No.
WTy OF CWINiINp CITY OF CUPERTINO
/{.�tWARR DM, APPLICATION FOR BUILDING PERMIT Ye, 75"
JANj
t o g72 19 Sanitary No.
-»L Permit No.
E 'E pp kation is hereby made for a permit to
3 a A lop story,TypeY18w
) Building
U to be occupied only as Z7Aky y7 L400.l 44e o%,,y fteA? in accordance with
o g2
° °' Plans, Specifications and Plot -Plan feled herewith PI Ck Fee a�
T m
e - DDD L9 Fee $
/ �3
Estimated Value of Improvements, $ !3 // // 3�7 ,-�5—
o `o It is hereby agreed that the requirements of the Cupertino Building and ZXingOZndn and
> all other laws applicable to the construction, location, and use of buildings within the City of
G A Cupertino will be complied with.
c
3
Owner K a-,�� Address
OP
By < Address K
FPhone k Ck se -IF Appro�edState License u,. 2 S�•