FILE 51,140A6 /
No. �
Lot No.
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTiNO
File No. ss
Da to 196 Sanitary No.--�7 rk
� � L
Application is hereby made for a permit to
to be occupied only as
accordance with Plot Plan, Plans
Type
filed herewith,
Estimated Value of Improvements f
•
FEES e Plan Check f
Owrmr
Contr. Address
Phone C -.L ��T— State License A& _ __
Approved
Date
Contr.
APPLICATION FOR ELECTRICAL PERMIT
— 196 FEEf
Address
Phone State License
Date
Contr.
Phone
Do to
Contr.
Phone
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
196 GAS FEE f —
PLUMBING FEE f
Address
State License
Approved
APPLICATION FOR APPLIANCE PERMIT
196 FEES
Address
State License
Approved
Applicants agree not to violate any of the
Workmen's Compensation Laws of the
State of California
RECORD OF INSPECTION APPROVALS
BUILDING
FOUNDATION
iOUND
UNDERFLOOR
DATE
IRING
INSPECTOR'
FRAME
DATE
DATE
INSPECTOR
LATH & PLASTER
FINAL
DATE
DATE
INSPECTOR
INSPECTOR
DATE
INSPECTOR
DRAIN
DATE
INSPECTOR
ELECTRICAL
INSPECTOR
ELECT.
UNDERG
ROUGH V
FINISH 4
FIXTURI
MOTORS
FINAL _
iERVICE
iOUND
DATE
INSPECTOR
IRING
DOTE
INSPECTOR
IRING
DATE
INSPECTOR
S
DATE
INSPECTOR
DATE
INSPECTOR
DRAIN
DATE
INSPECTOR
DATE
PLUMBING & GAS
INSPECTOR
?RGROUND
DATE
INSPECTOR
'IAL ROUGH
DATE
INSPECTOR
fH COMPLETE
ATE
N PECTOR
DRAIN
DATE
INSPECTOR
1IPING
DATE
SPECTOR
3d
L
- SPECTOR
_, DATE(s
INSPECTOR
0 A r C I1.r GV I --
APPLIANCE
INSPECTED
DATE
MISC
DATEI 1
MISC
DATE i
MISC
DATE
INSPECTOR
INSPECTOR
INSPECTOR
INSPECTOR
Or
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
M Sewer Connection
E3-*'f-1umbing Final
0
Owner or Tenant
At .06
Tract ..................
Date Connected ..
Date Final ..........
111 12/66-1M
Bldg. Dept.
Office Copy
Sanitary Permit No. ------
Plumbing Permit No . ............................
LotNo . ................................
.................................................
.......................... ........................... ig.
........................
PLR B&6 INSPECTOR
, OFF MCCi-ttt /jam ewof S/ta-sum'Y Qp
/0c kl IVIG f''fy // /1, A Y LOT NO,
NO. STREET
�> r77
AP f$19ATION, FOR APPLIANCE PERMIT
i ¢ i J/ C1TY OF CUPERTINO
=LL y11969
0 < Date , 2 0 196 Permit No. �r
T R
' W "—N /Appplicatiion is hereby mRde to the City -of Cupertino for a permit to
0 F install gas appliances as listed on the reverse side hereof, and agrees to
zw install said appliances in accordance with the provisions of the Plumbing
„ i Code of the Citv of Cupertino, and all other laws applicable thereto.
3 n Use of Pr raises A A C t f/I�. L
00
50
Owner JeAddresZ06/ 'Y %/6 h N�y
ZJ
J zDy - Address
J"O CONTRACTOR, AGENT
3�
—a
Phone.
dz
vw
ao State License Approve
U PLUMBING INSPECTOR
N.
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