NO PERMIT NUMBER Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO ./
File No.
Sanitary No.
Date 196
A plica LianKa hereby made for a permit to
story, Type
to be occupied only as
in accordance with Plot Plan, Plans and Specification filed herewith,
.Estimated Value of Improvements $
FEE$ Plan Check $
Owner Address
Contr. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Data 196 FEES
Contr, Address
Phone State License
Approved '
APPLICATION FOR PLUMBING & GAS PERMIT
Date 196 GAS FEE $
PLUMBING FEE $�����Q=ate
Contr. Address &S-0 -' _" a�- C
? y
Phone 379 .-042 State License aJ���z k/
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEE$
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.APPROVAL'S
FOUNDATION BUILDING
Date Inspector
UNDERFLOOR
Date Inspector
FRAME
Date Inspector
LATH & PLASTER
Date Inspector
FINAL
Date Ins oe c for
ELECTRICAL
.OUTLETS
SERVICE SIZE
SWITCHES UNDERGROUND
Date Inspector
RECEPTACLES ROUGH WIRING
-
FIXTURES FINISH WIRING Date Inspector
H,P, CHARGE FIXTURES Date Inspector
Date Inspector
PERMIT FEE Motors
Date Inspector
TOTAL FEES FINAL
Date Inspector
PLUMBING & GAS.
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
WATER SYSTEM SIZE IATERIAL
TOTAL FIXTURES sL—. UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Date Inspector
MAIN DRAIN FEE ROUGH COMPLETE
_ Do to Inspector
STORM DRAIN FEE MAIN DRAIN
Date Inspector
WATER SYSTEM FEE GAS PIPING
/Dote or.
GAS PIPING FEE I FINAL —`— a
Data nspector
PERMIT FEE o-0 MISC
Date Inspector
TOTAL FEE � � S"d '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 FEE
FLOOR FURNACE , TOTAL FEE
INSPECTED
Date Inspector