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NO.STREET
w APPLICA:T,ION FOR BUILDING PERMIT
r O E C "CITY�OF CUPERTINO
Q 4
0' Sanitary No.
5 �f1 rsT
w O Date fro ., 1967 16 Fermit No.
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Application is hereby de for a permit
° (ITS OF (11'aC�i'�'t(+ '
z N a p lding
<w
o
tbe occupied o
if
o 'o in accordance with Pla , Specifica ns and PIIan filed herewith. y
F 3 Estimated Value of Improvements, $� DQ i� Fee
—�
i J it is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
= all other laws applicable to the construction, locatiop, and use of buildis within the City of
d o Cuperti u will be compli`re''d with. �Ca& Al, � S% /
3 Owner�-�`�6 4VAAt Address (/
rcagn'wni s�ibNS ("�M.Qti Address
ww
< U Phone— "% -IS - Va-SW� Approve
,1. State Licens
DING INSPECTOR
�3 J
RECORD OF INSPECTION APPROVALS
FOUNDATION
DATE.
INSPECTOR
UNDERFLOOR
DATE
INSPECTOR
FRAME
j
DATE.
INSPECTOR
LATH and PLASTER
DATE
INSPECTOR
FINAL BLDG.
j
DATE
INSPECTOR
FINAL ELEC.
DATE
INSPECTOR
FINAL PLBG.
DATE
INSPECTOR
FINAL GAS
-'
DATE
INSPECTOR