FILE 51003/V .7 7A I `1 W Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No. JT—'1ri
Sanitary No.
IC
Date 196
Application is hereby made for a permit to w
a stay, T e'� �j' 7Xi'
to be occupied only as
in .cordance with Plot Plan, Plans
and Specification filed herewith,
Estimated Value of Improvements $
Y
FEES 4- - . Plan Check $ )_
Owner Address
Contr. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
Contr, Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT "
Dote 196 GAS FEE f
PLUMBING FEE $
Contr" Address '
Phone State License
._. Approved
APPLICATION FOR APPLIANCE PERMIT
Dote 196 FEES
Contr.' ' Address
Phone' State License
Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State of California '
PAD FINAL
RECORD OF INSPECTION ,APPROVALS GRADING FINAL
FOUNDATION BUILDING
Date Inspector
UNDERFLOOR
Date Inspector
FRAME
Date Inspector
LATH & PLASTER
Det •pector
FINAL
Date Ins oe c ter
ELECTRICAL
,OUTLETS
SERVICE SIZE
"SWITCHES UNDERGROUND
_ Date Inspector
RECEPTACLES ROUGH WIRING
Date Inspector
FIXTURES FINISH WIRING
Date Inspector
N.P. CHARGE FIXTURES
Date Inspector
PERMIT FEE Motors
Data Inspector
TOTAL FEES FINAL
, Data Inspector ,
PLUMBING & GAS
MAIN DRAIN SIZE I I MATERIAL
STORM DRAIN I SIZE I LIMITERIAL
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Date Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Date Inspector
STORM DRAIN FEE MAIN DRAIN
Date Inspector
WATER SYSTEM FEE GAS PI NG
Date Inspector
GAS PIPING FEE FINAL
Date Inspector
PERMIT FEE MISC
Date Inspector
TOTAL FEE 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
Data Inspector
LOT NO.
NO. STREET 1.
w p �d�LFT#^LI FOR BUILDING PERMIT
M ° D OF CUPF.RTINO
sU (FEB 15 1965 - sanitary No.
_ , Date 196 _ ermit No. ���� D 3
r0
4 �I�c at is it to
a
story p Building
W
W I to be occupied only a
a
0 o in accordance with Plans, Specifications and Plot-Plan filed herewith. av
� "; Estimated Value of Improvements,$ �n n Fee$3
OJ It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
* = all other laws applicable to the construction, locatiup, and use of buildings within the City of
0 Cupertino will be comp le 'th.
3 < L LF S' �P�� f,o, cf
— m Owner Address
W
W a By Address
0s
U Phone
Approved
State License BUILNG INSPECTOR
RECORD OF INSPECTION APPROVALS
FOUNDATION
DATE INSPECTOR
UNDERFLOOR � '-
DATE INSPECTOR
FRAME
DATE INSPECTOR
LATH End PLASTER
DATE INSPECTOR
FINAL BLDG. a
DATE INSPECTOR
FINAL ELEC.
DATE INSPECTOR
FINAL PLBG.
DATE INSPECTOR
FINAL GAS
DATE INSPECTOR