51167 1 1 �.�}�(•V Vim/
77sI " �li�► Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No. \12�C ,7
Sanitary No.
Date � �� 196
Application is hereby made for a permit to
n story
to be occupied only as
in accord nce with Plot Plan,-plans d Specification filed herewith,
Estimated Value of Improvements $ T a Q Q d O
' s
FEE$ Plan Check E
I Owner Address
Contr. Q Address duG c.•+.es.a�C•.� ,d2.�i
Phone State License 5; 740of
Approved 1
6.4
APPLICATION FOR ELECTRICAL PERMIT
Date �s3 196 FEE$ -? �-
Contr.. `'ems-i- / -.�-�.� Address 3l 7 3/-7
Phone --;2-4 r7- �l V- / State License 2- (j(o /
Approved �� -�^ • ^"��
APPLICATION FOR PLUMBING $ GAS PERMIT
Date 196 GAS FEE $
PLUMBING FEE $ J�
Contr. _ � Address - �j
Phone �� ! �'J �� State License I�f G
Approved 64)
APPLICATION FOR APPLIANCE PERlSSU�
Date Q�2 /gip 196 � FEES
Contr. /b� it QC�f's`�O Address
Phone 1>r7.--�/ ���- State License
f / )
Approved 666000///
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State of California
RECORD OF INSPECTION APPROVALS
_�
BUILDING
FOUNDATION 04-Gr
DATE INSPECTOR
UNDERFLOOR
DATE INSPECTOR
FRAME
DATE INSPECTOR
LATH & PLASTER
DA ECTOR
FINAL - '
DATE INSPECTOR
ELECTRICAL
ELECT. SERVICE �A^ 2z-fF
aTE INSPECTOR
UNDERGROUND
DATE INSPECTOR
ROUGH WIRING
DATE INSPECTOR
FINISH WIRING
DATE INSPECTOR
FIXTURES
DATE INSPECTOR
MOTORS
T INSPECTOR
FINAL
DATE I ECTOR
PLUMBING & GAS
UNDERGROUND � U- 6y y`
DATE INSPECTOR
PARTIAL ROUGH
DATE INSPECTOR
ROUGH COMPLETE
DATE INSPECTOR
tA
DR N
J� <TOR
PIPI ECTOR
L
DATE INSPECTOR
MISC
DATE INSPECTOR
MISC
DATE INSPECTOR
APPLIANCE
INSPECTED v
DATE INSPECTOR
MISC
DATE INSPECTOR
MISC
DATE INSPECTOR
MISC
DATE ' INSPECTOR
TRENCHING PERMIT
SIDEWALK -PERMIT 0
DRIVEWAY APPROACH PERMIT N . 325
o CITY OF CUPERTINO
Fee 60
----------------- Datt 4-.? .
,
............. 196
Permission Is Granted t --- & .... ... V . .... .........2.....
..
Location ............... A./--- ....... . ........ ....... . .. .... . ...... .............. ..... .. ....
Purpose ----------- . ..........-
Contractor ......................... .................................................................................
NOTE: All work shall comply to all conditions me Ordinance 130.
Issuedby ........................................
RECORD OF INSPECTION
......... ..**... .. .... .... ..*------ ---- -----------
DATE TIME INSPECTOR
------------------------------------ ................................ ................................................
DA,[71 TIME INSPECTOR
PAT I TIM Ii INS P FC To R
............................ .................................... ................................................
DA 1717 TIMEINSPrCTOR
NOTE: Inspector must he given 24 hours notice on each Inspection. 115 q/6o-5oo