51129 Lot No.
No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
File No.
Sanitary No.
Do to *' 196
App 'catiois' ere ade folaper t to
story, Type
to he occupied nnl as
n accordantroe.e.ts
t Plan, flans and Specification filed herewith,
Estimated Value of Imp $
FEES Plan Check $
Owner 4E Address
Contr. Address
Phone State License
Approved
APPLICATION FOR ELECTRICAL PERMIT
Date 196 FEE$
Contr. Address
Phone State License
p
� Alk
Approved
1iU1IQNr.FWLDII
G8 GAS PERMIT
Date 337�� 196666 11�%®® q� GAS FEE $ F
�fY OF C P 1/N0 PLUMBING FF c
Contr. Address 7.4 n Q J
Phone State License .2—a , j
VIjII L1AM D.
Approved BENEVIV-'
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEE$
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
Dote .Inspector
FRAME
Date Inspector
LATH & PLASTER
Date Inspector
FINAL
Date Insoectar
ELECTRICAL
,OUTLETS SERVICE S17_E
SWITCHES UNDERGROUND
RECEPTACLES ROUGH WIRING Date Inspector
FIXTURES 'FINISH WIRING Date Inspector
H,P, CHARGE FIXTURES Date Inspector
PERMIT FEE Motors Date Inspector
Date Inspector
TOTAL FEES FINAL
Date Inspector
PLUMBING & GAS
MAIN DRAIN SIZE I MATERIAL -
STORM DRAIN SIZE LaM TERIAL
WATER SYSTEM SIZE IATERIAL
TOTAL FIXTURES UNDERGROUND
FIXTURE FEE PARTIAL ROUGH
Date Inspector
MAIN DRAIN FEE ROUGH COMPLETE
Date Inspector
STORM DRAIN FEE MAIN DRAIN
WATER SYSTEM FEE �� GAS PIPING Date Inspector
I
GAS PIPING FEE FINAL — 'LS Date
Date Inspector
PERMIT FEE —r* MISC
pp 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 PLUMBING PERMIT
z a CITY OF CUPERTINO
W
W
x o Sanitary No.
0 4 f
3 U Date // -- 196 Permit No
a
= a Pee $
O Application is hereby, made to the City of Cupertino for a permit to install plumbing
oa pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
i N and/
fixtures in accordance with the provisions of the Plumbing Code of the City of
a W Cupertino, and all of r-laws applicable-ther'to.
wx V
W Use of Pre ' es i
00
3 Owner Addres
J� J �J
o By 1 Addre /
3 F CONTRACIO A NT
a Phon 7
WN Z
ao State License 0 T �Z—�'•' Approved
-0 16o PL@ BING INSPECTOR
FIX I uhl"b NWN BER MAIN DRAIN
UNITS FEES UNITS FEES
Ware, Heate Size
Water Closets Material
Bath Tubs To Curb
Showers To Prop. Line
Lavatories To Existing
Kitchen Sinks Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Machines 6 Size
Water Softeners Material
Bar Sinks To Main Drain
Com . Sink s Trays To Curb
Dental Units
Drinking Fountains
Floor Drains WATER SYSTEM
Hoppers Size
Restaurant Sinks Material
San Traps TOTAL FEES
Urinals Fixture Fee
Area Drains Main Drain Fee
eater Leaders Storm Drain Fee
Sprinkler valves Water Sys. Fee
Permit Fee Z tL—�
TOTAL TOTAL FEE o�
R CORD OF INSPECTION
Underground Rough...
Partial Rough..
Rough. Complete..
Main Drain
Final...