NO PERMIT NUMBER (2) Lot No. I,43A
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No.
Sanitary Nox7dj�
Dat196
V
Application is hereby mode for a permit to ee��
• a esf. story Type T
to be occupied only as 05111,
in accordance with Plot Plan, Plans and Swification filed herewith.
F�jputed Value of Improvements $ 440 0
FEE$ err
ww Plan Check j
L
Owner `�� Address
Contr. f'YQ Q Address
9a
Phone �A2 �la�J State License /Jr/ 7 `
Approved WII 11Au n RFNEVICNr
APPLICATION FOR ELECTRICAL PERMIT
Date 196 o FEE$ ,'fes
Contr. -- e 4;— "=� Address d'1
Phone 7 6 — s�c�'� State License
Approved WILLIAM n_ nf3NRVIr_&s
APPLICATION FOR PLUMBING & GAS PERMIT /
Date / 196 QV GAS FEE $
PLUMBING FEE $ d'a
Contr. Address 1-Zu
Phone �' 1J State License 11)-a fO79 ,f
Approved
APPLIPTION FOR APPLIANCE PERMIT ia, �--
Date 1% FEES
Contr. Address "'-
Phone -2 State License
- WILLIAM D. LZjgjZVICIi
t- Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State of California
RECORD OF INSPECTION APPROVALS
FOUNDATION pq¢�6 ly—
—D�_e`
UNDERFLOOR r
wr F.
Inspector
FRAME
17 Da ,
LATH & PLASTER "L Inspector
D e s
FINAL
Date Inseector
ELECTRICAL
OUTLE S SERVICE SIZE
SWITCHES UNDERGROUND
RECEPTACLES ROUGH WIRIN
6 Inspector
FIXTURES FINISH WIRING �b V ate Inspector
Date Inspector
H.P. CHARGE FIXTURES
PERMIT FEE Motors _Date Inspector
Date Inspector
TOTAL FEES FINAL b'yk
Date Inspector
PLUMBING 3 GAS
MAIN DRAIN SIZE MATERIAL
STORM DRAIN SIZE MATERIAL
WATER SYSTEM SIZE ITERIAL
TOTAL FIXTURES UNDERGROUND �y
FIXTURE FEE PARTIAL ROUGH J
Do pector
MAIN DRAIN FEE ROUGH COMPLET
�
STORM DRAIN FEE MAIN DRAIN/0 —
Do
D
WATER SYSTEM FEE GAS PIPING GO
D s
GAS PIPING FEE FINAL
Dete pector
PERMIT FEE MISC
afe napeefor
TOTAL FEE - MTSC -
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 PE*tT FEE
FLOOR FURNACE p�TOTAL F
INSPECTED / —�o
Date Inspector