322 (2) �( 4 -C'C's "I LOT NO.
NO. STREET
APPLICATI N FOR BUILDING PERMIT
{�
CITY OF CLIPERTINO
Da F������"'II , 195_ �Rermit No. —Z-2,2 __
—d( tf�3�tta permitto
a story,Type ..� 1T Building
atCITY OF C1-
to be occupied only as �<'e �
in accordance with Plans, Specifications and Plot-Kan filed herewith. r[I
Estimated Value of Improvements, $ �� Fee$
vIt is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
a all other laws applicable to the construction, location, and use of buildings within the City of
v
Cupertino will be complied with.
l Owner J��i , Address/3g&.1i1Li ,�ye
By JGaw Address �,e ,�l CONTRACTOR, AGENTPhone_ �y 4 7F Approved
BUILDING INSPECTOR 9�
RECORD OF INSPECTIOQQNkAPPROVALS
1 �
FOUNDATION
DATE INSPECTOR
FRAME
DATE INSPECTOR
LATH and PLASTER —
D TF INSPECTOR
FINAL BLDG. .•—
D H INSPECTOR
FINAL ELEC.`
DATE INSPECTOR
FINAL PLBG. ,
DATE INSPECTOR ;',-I.
FINAL'GAS
,SAA A
DATE INSPECTOR
�