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&,e 7t `"t' LOT Nn._
NO. STREET
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
No.y? / _
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to be occupied only as ze Z --Z & -< /
in accordance with Plans, Specifications and Plot-Pafiled herewith. O
Estimated Value of Improvements, $ eel 1 Fee $
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
Cupertino will be complied with.
Owner I IlaI Address�.�/�S
By Address 19.2"141,41e, p j /,1DS
CONTRACTOR, AGENT
Phone Approved �t u
BUILDING INSPECTOR �`�,
RECORD OF INSPECTION APPROVALS
FOUNDATION
I':ATF
INSPECTOR
FRAME
�—
DATE
INSPECTOR
LATH and PLASTER
—
DATE INSPECT R
FINAL BLDG.
ATE
- INSPECTOR
FINAL ELEC.
DATE
INSPECTOR
FINAL PLBG.
DATE
INSPECTOR
FINAL GAS
DATE
INSPECTOR