444 LOT NO,
AP I� "ATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Date , 195_ Permit No. �
Application is hereby made for a permit to
a /�story,Type Building
at
to be occupied only as a ze'4'yr
in accordance with Plans, Specifications and Plot- lan filed herewith.
Dd
Estimated Value of Improvements, $ Fee$ a2 •0'0
u It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
all other laws applicable to the construction, location, and use of buildings within the City of
"1 Cupertino will be complied
with.
n
Ii Owner � t11q'— Address
By —�// Address t
hVNTRACTOR, AGENT
Phone/- 3 Approve
W111SPECTOR
A 4
RECORD OF INSPECTION AP 0 S
. ,.
FOUNDATION F
DATE INSPE TOR
FRAME
DATE INSPECTOR•
LATH and PLASTER
TE INSPECTOR
FINAL BLDG.
D TE INSPECTOR '
FINAL ELEC.
DATE INSPECTOR
FINAL PLBG.
DATE INSPECTOR
FINAL GAS
DATE INSPECTOR