NO PERMIT NUMBER l 0 7 t Lot No.
No. Street ,
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Sanitary No.
/ File No. h -C1
Dote �796 .�
Application is hereby made for a permit to
a story, Type
to he occupied only as
in o cordance with Plot Plan, Plans and S cification filed herewith.
Estimated Value of Improvements $
FEES Pion Check $
Owr,er 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
Data 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 .
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 REQ.
SANITARY N0.
UNDERGROUND ROUGH
PARTIAL ROUGH
ROUGH COMPLETE
MAIN DRAIN
FINAL PLBG.
FINAL GAS
FINAL APPLIANCE
DATE INSPECTOR MISC.
MISC
MISC
f
I
MISC
Bldg. Dept
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
E241 wer Connection Sanitary Permit No. ..........
Plumbing Final Plumbing Permit No.
LotNo. .!:.._.....................
........... ........ --- .................................
Owner or Tenant 45... ... .. ............ ....
At -----v��7ko-q........... .. . ...... ......................................
IITract .......................................................................................................... ............
---- - ..................... 1 9
q --� --- ----
Date Connected ----------------------------------------_.1..:.1?..........-
DateFinal ------- ..................................----------- . .... .... .. ..... ..................... 19--
...........k ... ....... . . . . .. . ........ .. .....
PLUMBING
LUMBING INS CT R
Ill 7/63-IM
r
c ifrStrect Lot No. /
o APPLICATION FOR PLUMBING PERMIT
E CITY OF CUPERTINO
UG
Sanitary No. � 2- 7!
�F. Date - 1: , 196-. Permit No./0 ?
712
d�����Q
3 Fee$�
° Application is hereby made to the City of Cupertino for a permit to install plumbing pipes
and/or fixtures listed on the reverse side hereof,and agrees to install said prices and/or fixtures
in accordance with the provisions of the Plumbing Code of the City of Cupertino,and all other
'E laws applicable thereto.
Use of Premises
° U
S °
Owner-11 Address
c n
rn By Address
Contractor,Agent
3 Phone)' 21,�_�,� S'
�- State License Approved
Plumbing Inspector !i
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