NO PERMIT NUMBER Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Sanitary No. L V M.
-70 File No./Q
Dote � 196 L
��/ Application is
hereby made for a permit to
.. ' f/v tS�-1 L (SAJC12- LA.� 'i -
story, Type
to he occupied only as a6-T-0er-n .L/i✓ec:- e-) AJ Ly
in accordance with Plot Plan, Plans and Specification filed herewith„
Estimated Value of Improvements $
FEES Plan Check $
D..nar T0M&J MARDIQIUY Address 10381 I'��cikc. AvE•
252 � e
Contr. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEES
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Datil 124 196 74 'GAS FEE $ r'/0
PLUMBING FEE $
Contr. _e' P��� -SLS � ,. Address /U -79"1 'Od 2t MC�[.��
Phone �96 -7-9S7o7-9 S7 ) State License y�116 775
Approvedy13�-r,77,r
APPLICATION FOR APPLIANCE PERMIT
Data 196 FEE$
Contr. Address
Phone " State;License
Approved
Applicants agree not to violate any of the
Workman's Compensation laws 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.
UNDERGROUNDROUGH
ROUGH WIRING
FINISHED WIRING
FIXTURES _
MOTORS
FINAL
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR MISC.
BACK FLOW REQ.
SANITARY NO.
UNDERGROU4OUGH
PARTIAL RONiorw DIRROUGH COMN cR&Leo. PN6cKeo e eg4r.d"e�rr$ ARe OK•
FINAL PLBGFINAL GAS
FINAL APPL
DATE INSPECTOR MISC.
MISC
MISC
MISC
Bldg. Dept.
Office Copy
BUILDING INS CTORwS OFFICE
CITY OF CUPERTINO
JP Sewer Connection Sanitary Pe.rmit No. .... .V.. .j_:........
Plumbing Fin.al Plumbing Permit No. �.l........
Lot No. ......._..-.-"'............
Owneror Tenant t�---- �Z..rf.............................I.......I...... ------ ...............
At ..... ....... ......t�Af.................................................................7.........
Tract .............................. ................................................................................................
DateConnected ........F..-.3 v....... ................................................................. 19......------
DateFinal ............. ......./_j........?.&;....................................................../1 19............
6Z
...................... ...... la........................
-PLUMBING INSPECTOR