NO PERMIT NUMBER t;P,/( `f/I � Lot No.
No. Spear
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File
Sanitary No.
Do to 9010, 3 1966
pplication is hereby made for a permit to yyy
a s T pe'
to be ncct ed only as 1'
in accordance with Plot Plan, ens-and Specifico[i n e ith•,
' Estimated Value of Improvements S R /N /
FEES e k A
Owner ''
Contr. (t 'ys
Phone State
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEE$
Contr., Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date 196 GAS FEE b
PLUMBING FEE $
Gwwir. Address OZ/(o *e/
Phone f 3 :04/s—— State License
�/0 , l _ - _•_
Approved w '�`�/ 4,e
APPLICATION FOR APPLIANCE PERMIT
Date I% FEES
Contr, Address
Phone .State License
R;
Approved
Applicants agree not to violate any of t
Workman's Compensation Latus of the.
State of California
r
RECOR4`OF INSPECTION APPROVALS-
BUILDING
FOUNDATION ,
Date Inspector
UNDERFLOOR
Dote Inspector
FRAME
' Date Inspector '
LATH & PLASTER ...
Dote Inspector '
FINAL
Dote Inspector
ELECTRICAL
,OUT E.TS
SERVICE SIZE
SWITCHES UNDERGROUND
Date Inspector
RECEPTACLES ROUGH WIRING
Date Inspector
FIXTURES FINISH WIRING _
Date Inspector
M.P. CHARGE FIXTURES
Date Inspector
PERMIT FEE Motors
Date Inspector
TOTAL FEES FINAL
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES 12 UNDERGROUND _
FIXTURE FEE PARTIAL ROUGH
Date Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Data Inspector
STORM DRAIN FEE MAIN DRAIN
Date Inspector
WATER SYSTEM FEE GAS PIPING
Data Inspector
GAS PIPING FEE FINAL
Date Inspector
PERMIT FEE MISC
�p ate Inspector
' TOTAL FEE � � �" M_ ISC
Date Inspector
APPLIANCE
TYPE OF APPLIANCE UNITS FEE TYPE OF APPLIANCE UNITS FEE
CIRCULATING HEATERS REGISTERS
BLOWER FURNACES COMBUSTION VENT
SUSPENDED UNIT MISC
GAS RANGE MISC
GAS DRYER PERMIT FEE
FLOOR FURNACE TOTAL FEE
INSPECTED