1404 (2) • '�' �. .LOT NO.
A NO. STRE BT`y," t
APPUGAg10N FOR BUILDING .PERMIT
4j4.41,0jCITY OF CUPERTINO
Date_ 195_ Permit No. O
Application is hereby made fora r(r�it to
a / story,Type — _
I at
to be occupied only as Q
I KID,
in accordance with Plans, Specifications and Plot-Plan filed herewith. yy e) p
Estimated Value of Improvements,$20—e—) .—U Fee$ O�
I y
It is hereby agreedd 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
a Cupertino will be complie .with.
n Owne Address
w
By— Address
_ �/� CONTRACTOR, AG'NT
eji Phon Approv
BUILDING INSP TO
RECORD OF INSPECT<•: „PPROVALS
FOUNDATION
DATE INSPECTOR' -'
FRAME,
DATE INSPECTOR
LATH and PLASTER
DATE INSPECTOR
FINAL BLDG.
DATE INSPECTOR
FINAL ELEC.
DATE INSPECTOR
FINAL PLBG.
DATE INSPECTOR
FINAL GAS
DATE /INSPECTOR