51037 2 '
A& Lot No./(/rte
No. Street
APPLICATION F BUIL G PERMIT
CITY 0 1 U 0
File No.
/0"011
10
Sanitary No.
Date 196
Ap isi
e6y made a permit
a story, Type
to be occupied o
in accordance with plot Plan, Plans and Specification filed herewith,'
Estimated Value of Improvements $
FEE$ Plan Check $
Owner Address
C ontr. Address
Phone State License
i
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEE$
Contra. Address
Phone State License
TaApproved
I
rl,6ON pl� P ING & GAS PERMIT
V li�
a
Dara 196 GAS FEE $
YTY OF ✓ INO PLUMBING FEE i i
Contr, i't-�'�gJ aa Address
Phone -ZE 6 / T3J State License
Approved WILLIAM D. DENEVICH
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 APPROVALS
FOUNDATION BUILDING
Data Inspector
UNDERFLOOR
Date Inspector
FRAME
Do to I ns pe ctor
LATH & PLASTER
Dote Inspector
FINAL
Date Inspector
ELECTRICAL
,OUTLETS
SERVICE SIZE
SWITCHES UNDERGROUND
Date Inspector
RECEPTACLES ROUGH WIRING
Date Inspector
FIXTURES FINISH WIRING
H.P. CHARGE FIXTURES Date Inspector
Date Inspector
PERMIT FEE Motors
r
Date Inspector
TOTAL FEES FINAL
Date Inspector ..
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE LOMTERIAL
WATER SYSTEM SIZE 11TERIAL
TOTAL FIXTURES . UNDERGROUND
FIXTURE FEE ,16V-C 'G PARTIAL ROUGH
Date or
MAIN DRAIN FEE ROUGH COMPLETE,/0-3 o'G
DatA 'Inspector
STORM DRAIN FEE MAIN DRAIN
Dgta r
WATER SYSTEM FEE GAS PIPING `30 '9
Dote Inspector
GAS PIPING FEE � � � FINAL '
Date Inspector
PERMIT FEE _ o7 MISC
Date Inspector
TOTAL FEE � M_ ISC
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 r
FLOOR FURNACE TOTAL FEE
INSPECTED
Date Inspector
LOT NO.
NO STREET
CITY OF CUPERTINO
�u 3 Q 11kikICATION FOR PLUMBING PERMIT
PSanitary No.
Data ,19_ Permit No. S O 3
Application is hereby made to the City of Cupertino for a permit to install plumbing
pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
Cupertino,and all other laws applicable thereto. ,
Use ofis ,!/ Work To d
Premises 000���-..000�...j��� /lis Performed
Owner Y �Y 1 r///YOw Address
4hone x 326—4 3Sa X4-S'�7 (Glace)
BYAddress
Contractor,Agent
Phone �/
State License �`^��-�J Approved /�' &-P -R--�i
Plum r Spector
I AGREE I WILL NOT VIOLATE ANY OF THE WORKMEN'S
COMPENSATION LAWS OF THE STATE OF CALIFORNIA.
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