NO PERMIT NUMBER (2) ���O I �r/LL/Gx �/{/f/�/f• Lot No.
No. Street
APPLICATIONF R BUILDING PERMIT
CITY CUPERTINO
.. File No. 10
Sanitary No.
Do to �196
Applicatio4herede a p it to
a story, Type
to be occupied only as
in accordance with Plot Plan, Plans and Specification filed herewith, .
Estimated Value of Improvements $
FEE$ Plan Check$
Owner t1`� i_/ i4_ e� �_ Address
Contr. Address
Phone State License
• Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEE$
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date 8 196 GAS FEE $
r
PLUMBING FEE $ 17 f-0
'
Contr AfAddress a2 A-9 A. '2".C_'t
Phone t]2- -7 State License '33
Approved '
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEE$
Contr. Address
Phone State License
I
y,
Approved
Applicants.agree not towiolate any, of the
Workman's Compensation Laws of the
State of-California
MT '
RECORD OF INSPECTION APPROVA:IS ,
BUILDING
FOUNDATION
Date Inspector
UNDERFLOOR
Date Inspector
FRAME
Data Inspector
LATH & PLASTER
Do to Inspector
FINAL
Date Ins ae 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 MATERIAL
WATER SYSTEM SIZE I— TERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Date Inspector
MAIN DRAIN FEE ROUGH COMPLETE
a D t
STORM DRAIN FEE MAIN DRAINlo
a
ate Ins pec or
WATER SYSTEM FEE GAS PIPING
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 t 'TOTAL FEE
t
INSPECTED
n..t.. ` Insoactor
I . a� , LOT NO.
NO, snr.E1
N < APP IG�4T,[ON FOR PLUMBING PERMIT C
z i � �, OF C[JPHRTINO
w
S?m
x a ® iulry Nn.
K LL ^
o a Datel I Permit: No/do; /r�
3 LLFees (�
x
� ° A i 4 t' n her ��1i� (�d of Cupertino fora omit to install lumbin
o a pipes A d fiouresvl7�tE41 h R IMPerse side Hereof, and agrees to install said rims
> and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other laws applicable thereto.
wx
Use of Premises
00
oa Owner_�'�CO=(2 2�� Address
J o By � 01441101>1
/ � 6v. Address •
CONTRACTOR, A .NT
w i Phon f 3 �1r7 73 G `
40 state uceus,A o2 31 it .'33 4 Approved_
U PLUMBING INSPECTOR /
i ' Y
' E . a = ■ „ E / ( E � ayul , R < � ( , a
( ) G [ / � : ( � - , , � EEZ � � � ` � � , ■ , � 3
) j
; (
222 § \ E _ \
i §
Bldg. Dept
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
Sewer Connection Sanitary Permit No. -r�.. ........
❑ Plumbing Final Plumbing Permit No. /00.../!57o....
)< —&qaAC fCoW Lot No. ................................
Owner or Tenant .....................
At ...... ------ ......
Tract .................. .... ..
DateConnected ......... .....................................................................
DateFinal ........................................ ......................... 19-.-.........
......... ...... . .........................
PLUMBING INSPE OR
III 7/63-iM