3036oL O 0 S' I C •L "L -QJ'` LOT NO
NO. STREET
z APPLICATION FOR BUILDING PERMIT
Y o CITY OF CUPERTINO
0
o Sanitary No.
W LL Date a 196 Permit No.
=O
LL ~ App kation Is hereby made for a permit to
oQ
i a a� story, Type a / Building
w i
to be occupied only as
0 o in accordance with Plans, Specifications and Plot -Plan filed he with.
F3 Estimated Value of Improvements, $ 7 6 Fee $ ��
z J It is hereby agreed that the requirements of the Cupertino Building and Zoning rdinances and
* Z all other laws applicable to the construction, locatiop, and use of buildings within the City of
:2 o Cupertino will be complied with. `f�' �l
3 a Owner? i �' r.Q � E , %Y• ai_-r _ Address .2
W a By Addresscr
0 i
a 0 Phone L - - Approve
State Licens BUILDING INSPECTOR
RECORD OF INSPECTION APPROVALS
FOUNDATION
DATE. INSPECTOR
UNDERFLOOR
FRAME
LATH and PLASTER
FINAL BLDG.
DATE INSPECTOR
FINAL ELEC.
DATE INSPECTOR
FINAL PLBG.
DATE INSPECTOR
FINAL GAS
DATF. INSPECTOR