3027/IV
LOT
No. ,STREET
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Sanitary No.
Date r / 19fi. Permit No.
plication is hereby made f ermit to L
a story, Type /_ Building
to be occupied only as O X o2
in accordance with Plans, Specifications and Plot-ELay_filed herewith.
Estimated Value of Improvements, $/ Fee $
It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
all other laws a licable to the constru n, location, d use of buildings within the City of
Cupertino will b com Ile
Ower/p/%/� _r.��� Address/OfL/l 1O
By Address
Phonex
Approve
State License BUILDING INSPEgf0R
RECORD OF INSPECTION APPROVALS
FOUNDATION
UNDERFLOOR
DATE INSPEC"EOR
DAPI. INSPECTOR
FRAME
DATE
INSPECTOR
LATH and PLASTER
107
Dn
INSPECTOR
FINAL BLDG.
Z
_.I
DATE
INSPECTOR
FINAL ELEC.
.•A
FINAL PI -BG.
DATE INSPECTOR
DATE INSPECTOR
FINAL GAS
DA'rn . INS PPC'I OR
1