NO PERMIT NUMBER No. � Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File NoAgo,Q
Sanitary No.
196
App 'c¢ ' is ereby made for a permit to
400
'y story, Type
o e p ns
accord c jt an, an a Specification filed herewith,
s ata lu f r is $
FEES n $
Owner dr
Contr. Ad ass
Phone License
Approved
CVS
D � =
ASEP 219064
APPLICATION FOR ELECTRICAL PERMIT
Data � 6 FEES _ 3::
L._a u�..d /� I
Contr. ',// "Al!'l�ss �V 7���w.. /—�/��i
P �o2..% 7xo✓�a —(f 7xo 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
State of California
RECORD OF INSPECTION APPROVALS
FOUNDATION BUILDING
Date Inspector
UNDERFLOOR
Date Inspector
FRAME
Date Inspector
LATH & PLASTER
Data Inspector
FINAL
Date Insoector
ELECTRICAL
,OUTLETS SERVICE SIZE
SWITCHES UNDERGROUND
Date Inspector
RECEPTACLES ROUGH WIRING
Date Inspector'
FIXTURES FINISH WIRING
Date Inspector
H.P. CHARGE FIXTURES
Data Inspector
PERMIT FEE Motors
Date Inspector
TOTAL FEES FINAL
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN I SIZE I LOMATERIAL
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES UNDERGROUND -
FIXTURE FEE PARTIAL ROUGH
Data Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Date Inspector
!STORM DRAIN FEE MAIN DRAIN
Date, Inspector
WATER SYSTEM FEE GAS PIPING
Date Inspector
GAS PIPING FEE FINAL
Date Inspector
PERMIT FEE MISC
Date Inspector
TOTAL FEE MISC
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
Date Inspector