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n r Application is hereby ma a or a perrriit to �FL LC 1
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'z Ian a ((-) tJ Z� story,Type r `C`^A L `Y ��S� C . s a Building
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a to be occupied only aS(DQ I—ACE QI c1Q
o o in accordance with Plans, Specifications an Plot-Plan filed herewith. t/p
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Estimated Value of Improvements, $ Fee$ \
z J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
J z all other laws applicable to the construction, Idcztion, and use of buildings within he City of
t 2 0 Cupertino W complied with.
_ `m OwnerX t .Cf�e�,� (— Address
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RECORD OF INSPECTION APPROVALS
FOUNDATION
UNDI!RPLOOR
DALE INSPPCTOR
FRAME: j
DATE INSPECTOR
LATH and PLASTER
DATE INSPECTOR
FINAL BLDG. j
DATE INSPECTOR
FINAL ELEC. j
DATE INSPECTOR
FINAL PLBG. j
DATE INSPECTOR
FINAL GAS
DAI'R INSPECTOR
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