NO PERMIT NUMBER ! os-p o I / Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Sanitary No.
File No/.4.
Date '� 196 . _
Application is hereby made for a permit to
sees0sa sto Type Ls�..r
to be occupied only asO_ e D
in accordance with Plot Plan, Plans and Spec is ion ateil6.a.
Estimated Value of Improvements $
FEES G Plan Check $
Owner �• Address
Contr. Address
Phone 736 —3-1/ 7 State License l?�
Approved
APPLICATION FOR ELECTRICAL PERMIT
Data 196 FEES
Carat. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date 196 GAS FEE $
PLUMBING FEE $
Contr. Address
Phone State License
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 '
Stale of California
RECORD OF INSPECTION APPROVALS '
BUILDING
DATE INSPECTOR MISC.
PAD FINAL
FOUNDATION
UNDERFLOOR
FRAME
LATH & PLASTER
GRADING FINAL
FINAL BLDG.
ELECTRICAL
DATE NSPECTOR MISC.
UNDERGROUND ROUGH
1
ROUGH WIRING
FINISHED WIRING
FIXTURES
MOTORS
FINAL [
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR MISC.
BACK FLOW REQ.
SANITARY NO.
UNDERGROUND ROUGH
PARTIAL ROUGH
ROUGH COMPLETE
MAIN DRAIN
FINAL PLBG.
FINAL GAS
FINAL APPLIANCE
DATE INSPECTOR MISC.
MISC
MISC
MISC
OFFICE COPY �%4
9LECTRIC SERVICE NOTICE
li BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
...........
............. ...........
To You are hereby uthorized to connect(e)ectrical service for
Owner or Tenan .............. ...... .... ....
. . ........................................
At ......... WQ
No. of Wires .................. Size of Wirl CS -4. ---- -:....... Size of Switch ! Qc).A�
MotorLoad .......................... Voltage ..... ..... --------- Phase ......................... ........
HeatingLoad ........................ K. W. ....... . ...... ...... ...... Voltage ................................
Light............... ]lo............ New Service.... .......-. Rnriect..................
No. of Meters...................
Heat................. e ................
.......... Move Service............
ee
ri
hr
h
No.of Add. Meters............ Power............... ........EThml ...............Move Meter...:.......
F
ELECTFUCAL
J A
............. INSPECT