File 100021es
Lot No.
No. Street a
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No./e:7457 a°7-/
/ Sanitary No.
Date 196 1
Application is hereby made for a permit to
a
to be occupied only as
story, Type
in accordance wit Vlot Plan, Plans and Specification filed herewith„
Estimated Value of Improvements u S
FEES �2 Plan-Check E
Owner Address
C. wtr. / ` Address
Phone �`� 7J State License /, �'/A /QQ��������� � ��
Approved "�94W -4 �+w+wV , /
APPLICATION FOR ELECTRICAL PERMIT
Date /S l 196 'S/ FEES
Conti. f- t�[.a..:.- Ct— c��c.. 4i Address/0
Phone � 2 A) O State License
Approved
Do to
APPLICATION FOR PLUMBING & GAS PERMIT
196
GAS FEE E
PLUMBING FEE $
Contr. Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEES
Contr
Phone
Applicants agree not to.violate any of the
Workman's Compensation Laws of the
State of California
Address
State Licons<
Approved
RECORD OF INSPECTION APPROVALS
SERVICE SV_E
I
BUILDING
UNITS
FOUNDATION
SWITCHES
Date
Inspector
Date
nspector
UNDERFLOOR
FIXTURES c2l_
it
e-o
Date
Inspector
FRAME
PERMIT FEE
Date
Inspector
D
Inspector
LATH 8 PLASTER
GAS RANGE
Date
Inspector
a
a ctor
FINAL
GAS DRYER
to
In for
Date
Insoectar
ELECTRICAL
SERVICE SV_E
I
.OUTLETS
UNITS
FEE
SWITCHES
Date
Inspector
RECEPTACLES
LwITERIAL
FIXTURES c2l_
Date
e-o
H.P. CHARGE
iTERIAL
PERMIT FEE
Date
Inspector
TOTAL FEES
UNDERGROUND
ELECTRICAL
MAIN DRAIN
SERVICE SV_E
I
UNDERGROUND
UNITS
FEE
CIRCULATING HEATERS
Date
Inspector
ROUGH WIRING
LwITERIAL
BLOWER FURNACES
Date
Inspector
FINISH WIRING
iTERIAL
SUSPENDED UNIT
Date
Inspector
FIXTURES
UNDERGROUND
GAS RANGE
Date
Inspector
Morors
PARTIAL ROUGH
GAS DRYER
to
In for
FINAL
ROUGH COMPLETE
Date
Date
Inspector
PLUMBING & GAS
MAIN DRAIN
MAIN DRAIN
I SIZE
I
I MATERIAL
UNITS
FEE
CIRCULATING HEATERS
STORM DRAIN
I SIZE
I
LwITERIAL
BLOWER FURNACES
WATER SYSTEM
SIZE
iTERIAL
SUSPENDED UNIT
TOTAL FIXTURES
MISC
UNDERGROUND
GAS RANGE
FIXTURE FEE
MISC
PARTIAL ROUGH
GAS DRYER
MAIN DRAIN FEE
PERMIT FEE
ROUGH COMPLETE
Date
Inspector
STORM DRAIN FEE
MAIN DRAIN
Date
Inspector
WATER SYSTEM FEE
GAS PIPING
Date
Inspector
GAS PIPING FEE
FINAL
Date
Inspector
PERMIT FEE
MISC
Date
Inspector
TOTAL FEE
MISC
Date
Inspector
vote 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
loot
No.
Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Dote 196
Application is hereby made for a permit to
a
to be occupied only as
Lot No.
File No/� -21
Sanitary
Z I�r V�AIt;�
in acc NAAce with Plot Plan, Plans and Specification filed herewith,
(I vv
Estimated Value of Improvements b J
FEE$ Plan Check $
Owner Address
6enrM Address
Phone ag fei 61
,
f Zr State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Data L/6- 196 FEE§
Cantr. Ct,.,&44"o ioG a i �I y�w 9
Address
Phone i S a' �0 0 State License // 7Q�6 ,� 7 '
,. Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Dote 196 GAS FEE $
PLUMBING FEE $
Contr.
Phone
Date-
Contr.
Phone
Address
State License
Approved
APPLICATION FOR APPLIANCE PERMIT
196 - 'FEE$
Address
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
Date
UNDERFLOOR
Date
FRAME
Date
LATH 8 PLASTE
FINAL
ELECTRICAL
UNDERGROUND
ROUGH WIRING
FINISH WIRING
FIXTURES
Motors
FINAL • �
PLUMBING & GAS
1'
Inspector
Inspector
I ns pe t for
fe In
�-Ins De ctor
SERVICE SIZE
I
Date
Date
Date
Date
A
Date
Inspector
Inspector
Inspector
Inspector
ns pe ctor
Inspector
MAIN DRAIN
I SIZE
I I MATERIAL
,OUTLETS
STORM DRAIN
I SIZE
SWITCHES
UNDERGROUND
RECEPTACLES
PARTIAL ROUGH
FIXTURES
H.P. CHARGE
- Inspector
MAIN DRAIN FEE
PERMIT FEE
ROUGH COMPLETE
TOTAL FEES
Do t6
ELECTRICAL
UNDERGROUND
ROUGH WIRING
FINISH WIRING
FIXTURES
Motors
FINAL • �
PLUMBING & GAS
1'
Inspector
Inspector
I ns pe t for
fe In
�-Ins De ctor
SERVICE SIZE
I
Date
Date
Date
Date
A
Date
Inspector
Inspector
Inspector
Inspector
ns pe ctor
Inspector
MAIN DRAIN
I SIZE
I I MATERIAL
TERIAL
STORM DRAIN
I SIZE
I LL4TERIAL
UNDERGROUND
WATER SYSTEM
SIZE
FEE
TERIAL
UNITS
TOTAL FIXTURES
CIRCULATING HEATERS
UNDERGROUND
FIXTURE FEE
PARTIAL ROUGH
BLOWER FURNACES
Date
- Inspector
MAIN DRAIN FEE
SUSPENDED UNIT
ROUGH COMPLETE
MISC
Do t6
Inspector
STORM DRAIN FEE
MAIN DRAIN
GAS DRYER
Date
Inspector
WATER SYSTEM FEE
GAS PIPING
TOTAL FEE
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
Do to Inspector