214/oo10
ix /
NO. STREET
W ® APPL'IC�ATION FOR BUILDING PERMIT
r o Gam. •� P�CITY OF CUPFRTINO
itr!t��61865Sanitary No.Zig
bite 196— Permit No.
r O
n W Application is hereby made for a permit to
i n a�stor e 3 %� , Building
aw
to be occupied only as .IIJ
2'0 in accordance with Plans, Specificat n� sand Plot -P d herewith.
Estimated Value of Improvements, $ Fee $ V �.
iJ It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
* z all other laws applicable to the construction, locatiop, and use of buildings within the City of
j o Cupertino vLi I be complied with.
Owner ✓E w G Addresse D
wz
W a By Address
< o
Phone 7 D
U — Approve
State License/� �/��� BUILDING INSPECTOR
RECORD OF INSPECTION APPROVALS
FOUNDATION
DATE INSPEC'T'OR
UNDERFLOOR
FRAME
LATH and PLASTER
DATE INSPECTOR
DATE. INSPECTOR
DATE INSPECTOR
FINAL BLDG.
DATE INSPECTOR
FINAL ELEC.
DATE INSPECTOR
FINAL PLBG.
FINAL GAS
DATE INSPECTOR
DATE INSPECTOR