NO PERMIT NUMBER /0 3 7/I !/CJ r 1K-"'i �i� Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No. SAO Q
/ Sanitary No.
Date ^ ( 196 7 -
r -
Application is hereby made
for a permit to �,1.},. �,/�J
�0.'`�1'� �"v ''Story' yp '
to be occupied and s U
in accordance with Plot Plan, Plans and Specification filed herewith,
Estimated Value of Improvements
FEES Plan Cheek $
Owner _ s'►c-�.+ Address
Contr, Address
Phone .2 S.3 — lo 9 S State License �7�--` l
Approved (�//�/
/ ) tCtJ C-a�"Ai'�
APPLICATION FOR ELECTRICAL PERMIT
Data 196 FEE$
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING 8, GAS PERMIT
Date 196 GAS FEE $
PLUMBING FEE $
Cont', Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 1% 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
BUILDING
FOUNDATION
DATE INSPECTOR
UNDERFLOOR
DATE INSPECTOR
FRAME
DATE INSPECTOR
LATH & PLASTER
DATE INSPECTOR
FINAL
DATE INSPECTOR
ELECTRICAL
ELECT. SERVICE
DATE INSPECTOR
UNDERGROUND
DATE INSPECTOR
ROUGH WIRING
DATE INSPECTOR
FINISH WIRING
_ DATE INSPECTOR
FIXTURES
DATE INSPECTOR
MOTORS
DATE INSPECTOR
FINAL
DATE INSPECTOR
PLUMBING & GAS
UNDERGROUND
DATE INSPECTOR
PARTIAL ROUGH
DATE INSPECTOR
ROUGH COMPLETE
DATE INSPECTOR
MAIN DRAIN
DATE INSPECTOR
GAS PIPING
DATE INSPECTOR
FINAL
DATE INSPECTOR
MISC
DATE INSPECTOR
MISC
DATE INSPECTOR
APPLIANCE
INSPECTED
DATE INSPECTOR
MISC
DATE INSPECTOR
MISC
DATE INSPECTOR
MISC
DATE INSPECTOR