NO PERMIT NUMBER Lot No.
/0
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO Q
Sanitary No.
File No.
r O
Dote. 196
Application is hereby made-for a permit to
- 0 a story, Type-
to he occupied only as
in ac ordance with plot Plan, Plans and 1pecification filed herewith.,
Estimated Value of Improvements $
FEE$ /� ���� ��+ Plan Check $
Owr,.r /"�^�� "e'y"p-.�.nn "L� Address y �j
Contr. Address OZ •Z- ^".."`�"`'�"c't./
Phone G 7 -qJ State License 7 7-s
Approved
APPLICATION FOR ELECTRICAL PERMIT
Dot. 196 FEE$
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date 196 GAS FEE $
PLUMBING FEE $
Cont,. Address
-
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEE$
Contr. Address
Phone State License
Appro'ved i
Applicants agree not to violate any of the
Workman Cs Compensation Laos of the.
State. of California
RECORD OF INSPECTION APPROVALS
BUILDING
DATE INSPECTOR MISC.
PAD FINAL
FOUNDATION
UNDERFLOOR
FRAME
LATH & PLASTER
GRADING FINAL
FINAL BLDG.
ELECTRICAL
DATE INSPECTOR MISC.
UNDERGROUND ROUGH
ROUGH WIRING
FINISHED WIRING
FIXTURES
MOTORS
FINAL
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR MISC.
BACK FLOW REO.
SANITARY NO.
UNDERGROUND ROUGH
PARTIAL ROUGH
ROUGH COME.L
MAIN DRAIN
FINAL PLBG.
FINAL GAS
FINAL APPLIANCE
DATE INSPECTOR MISC.
MISC
MISC
MISC