125 N ►L/ /il eC c 6<c f►v - f/c�
1 LOT NO.
NO, STREET
APPLICA ION FOR BUILDING PERMIT
a ° XTTY OF CUPERTINO
o a Sanitan No.
SU
W Date 196_ Permit No. �• •
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4 Application is hereby made for a permit to -eY
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�XlC) t tin ro a�x°*1'Ty Building
to be occupied only as ¢�"''(-.fes• �GLei.
0 o in accordance with Plans, Specificati Ins and Plot- ,�,a6filed herewith. 0,S)
Estimated Value of Improvements,b >!l00. Fee$ 7 �—
O <J It is hereby agreed that the req r'rements of the Cupertino Building and Zoning Ordinances and
* z all other laws applicable to the 2`onstrucV, locatiop, and use of buildings within the City of
j o Cupertino will be complied with.
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B �.[ %'. '. R �bt '. Address -2-
a� Phon _ - Appr .u.i�-ti.�
State License C 7 I BUILDING INSPECTOR
RECORD OF INSPECT I N; APPROVALS
I FOUNDATION
DATE. INSPECTOR
UNDERFLOOR
UA'C li INSPFCTOR'
FRAME
DATE INSPECTOR
LATH and PLASTER
ZDATE INSPECTOR
FINAL BLDG. + /�
DATE . INSPECTOR
I(' FINAL ELEC. j
DATE INSPECTOR
FINAL PLBG.
DATE INSPECTOR
FINAL GAS
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DATE wsPl:croa
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