NO PERMIT NUMBER Lot No.
No. Street
APPLICATION FOR BUILDING RMIT
CITY OF CU TIN
File No.
/ nitary No.
Date 196
Applica 'on is reby m for ermi to
a story, Type
to be occupie on Ly s
in accordance with Plot plan, Plans and Specification filed herewith„
Estimated Valve of Improvements $
FEE$ L 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
Date 196 GAS FEE $
PLUMBING FE�EE $
Contr. res �7'�c� p ' / �✓'- V
Phone T State License dq /e 7YS�
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 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
GRAD)NQ F)NAL
RECORD OF INSPECTION APPROVALS
BUILDING
FOUNDATION
Date Inspector
UNDERFLOOR
Date Inspector
FRAME
Date Inspector
LATH & PLASTER
Date Inspector
FINAL
Dote Ins oe ctor
ELECTRICAL
,OUTLETS
SERVICE SIZE
SWITCHES UNDERGROUND
Data Inspector
RECEPTACLES ROUGH WIRING
Date Inspector
FIXTURES FINISH WIRING
Date Inspector
H.P. CHARGE FIXTURES
Date Inspector
PERMIT FEE Motors
Date Inspector
TOTAL FEES FINAL
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE TERIAL
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
a I
WATER SYSTEM FEE GAS PIPING 3�
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
Dote Inspector