191 � (�(//J ie6
Z✓�,�.I.OT NO.
No. STREET
w Z APPLICATION OR BUILDING PERMIT
E �
>< 0 CITY OF CUPERTINO
0 - Sanitary No.
O J
m a Date M. " ermit No.
� o
r
o : Application is hereby made for a permi
a
i N a StnTvncs2 Building
a w
to be occupied only as
00 in accordance with Plans, Speci c ions and Plot g filed herewith. eo
Estimated Value of Improvements,$:� .T=, Fee$
i J It is hereby a reed that the requirements of the Cupertino Building and Zoning Ordinances and
J Z all other la pplicable to the construction, locatiop, and use of buildings within the City of
d 0 Cupert' a mpliedwith.
3 � Owne ^ Address's 1 — - -
- m
w Z
a Address
< 0L)
u Phon P? " 3 3 APProved
State Licens ZZB iLDING INSPECTOR
n
RECORD OF INSPECTION APPROVALS
FOUNDATION
DATE INSPECTOR
UNDERFLOOR
DATE INSPFCTOR
FRAME
DATE. INSPECTOR
LATH and PLASTER
DATE INSPECTOR
FINAL BLDG. j
DATE INSPECTOR
FINAL ELEC.
DATE INSPECTOR
FINAL PLBG.
DATE INSPECTOR
FINAL GAS
DATE. INSPECTOR