NO PERMIT NUMBER (2) Gr U I /� .5t-st-il-tti(.0-'A6L/ y.��i�l/*-"�-tl/�tX Lot No.
No. Street
CITY OF CUPERTINO
APPLICATION FOR BUILDING PERMIT
Sanitary No.
File No.
�j
Dare Y
19
Application is hereby made for a permit to
a story, Type
to be occupied only as
in accordance with plot plan, Plans and Specification filed herewith,
Estimated Value of Improvements $
FEE$ /'9 Jam,/^/ Plan Check $
Owner Address
Contr. V/(� Address
Phone 7.3 In^ �� State License
Approved iN- .CLz-C'-�c.�/
APPLICATION FOR ELECTRICAL PERMIT
Date 19 FEES
Centr, Address
Picone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Dore 19 GAS FEE $
PLUMBING FEE $
Cont, Address
Phone State License
Approved
�9LICATION FOR APPLIANCE PERMITPDare L1 -
/a-Contr. 3 Z
Address
Phone o S i6 /3 7,P o 3 —C zti
State License
Approved
Applicants agree not to violate any of the
Wor&mart's Compensation Laws of the
State of California
PD-1
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 REO.
SANITARY N0.
UNDERGROUND ROUGH
PARTIAL ROUGH
ROUGH COMPLETE
MAIN DRAIN
FINAL PLBG.
FINAL GAS
FINAL APPLIANCE
DATE INSPECTOR MISC.
MISC
MISC
MISC
i
CITY OF CUPERTINO C P Y'
COPT
GAS SERVICE NOTICE
To ....... 1973
You are hereby authorized to connect the GAS service for
Owner or 'Tenant ... .....4, ..... . .. ..'_... - __... p
/ New Service . .....
.........__......
No. of Meters __._..(..____.. Reconnect
Move Service ... .......... .......
..
No. of Add. Meters ....... ...... Move Meter
PLUMBING INSPECTOR