51114 / 2ZI Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
ee ,.Vt
File No.Sanitary No.
Date 196 " tAp licati n ' ere bym
a story, Type
to he occupied an s
in accordance with Plot Plan, Plans and Specification filed herewith,
'Estimated Value of Improvements $
FEE$ 4.a Plan Check $
Owr.er //I Y. ,ass
Cont,, Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Data 196 FEE$
Contr. Address
Phone State License
® j "
& •Approved
rI.tGAT�ON.F,ARtPIJUfd6ING & GAS PERMIT
Dote IYUY 1396( 1g9� {imp GAS FEE $
PLUMBINGFFEE $ r,
Cont,. ^� s ik / W� rtT
& �
Phone jr / /
icense /2'
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
Dote Inspector
FINAL
Date Ins oe ctor
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 I I MATERIAL
STORM DRAIN I SIZE I LOOLTERIAL
WATER SYSTEM SIZE 11TERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Date Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Do td Inspector
STORM DRAIN FEE MAIN DRAIN
' Date Inspector
WATER SYSTEM FEE �� GAS PIPING
9yte r
GAS PIPING FEE FINAL -GS
e � Date 77n.pector
PERMIT FEE oY 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
Data Inspector
Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No.
02/
Sanitary No.
Date �_�196
Application is hereby made for a permit to
/� e story Type
.to be occupier! only as ut _•�'
in accordance with plot Plan, Gas and Specification f ed herewith.
Estimated Value of Improvements $ OZ. 0041 IL4
FEE$ � Plan Check E
Owner Address
Contr. V Address A13'4"
Phone 75.2-.$ y3 J- State License t1� a it
Approved !i!/
APPLICATION FOR ELECTRICAL PERMIT
Data 196 FEE$
Contr. Address
Phone State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date 196 GAS FEE $
PLUMBING FEE $
Contr. Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Dote 196 FEE$
Canty. 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 8 PLASTER
Date Inspector
FINAL
Date Ins De c tar
ELECTRICAL
,OUTLETS
SERVICZ SIZE
SWITCHES UNDERGROUND
RECEPTACLES ROUGH WIRING Date Inspector
Date Inspector
FIXTURES FINISH WIRING
Date Inspector
'H.P, CHARGE FIXTURES
Data Inspector ,
EPEREMITFEE MotorsDate Inspector
FINAL
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE I I MATERIAL
STORM DRAIN I SIZE I IdOMTERIAL
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Date 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
' Data 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 _