51167 (2)CcAl-4., Ave, i37¢
LOT NO.
1�I NO. STREET
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APPLICATION FOR BUILDING PERMIT
OF CUPERTINO
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a v� �—�.:) Sanitary No.
i LL Date s ! ll"i `11 e'lvy _ Per it No. 'S 7
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n Application is hereby made for a permit to
a in a CITY I �.X �O S• r Building
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to be occupied only as K.(i
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o o. in accordance with Plans, Specificationst-Plan filed herewith. r
F; Estimated Value of Improvements, $ 7-W Fee S 3 o D
zo J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
z all other laws applicable to the construction, locatiog, and use of buildings within the City of
o Cupertino will be complied with.
3N OwneAddress
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u $y b<v4 I9 V A/OH LL' Address
`0Phone.Si-X2908' A roved
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State License /' '— BUILDING INSPECTOR /f
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RECORD
OF INSPECTION
APPROVALS
FOUNDATION
i
DATE -
INSPECTOR
UNDERFLOOR
DATE
INSPECTOR
FRAME
DATE
INSPECTOR
LATH and PLASTER
I
DATE
INSPECTOR
FINAL BLDG.
DATE
INSPECTOR
FINAL ELEC.
DATE
INSPECTOR
FINAL PLBG.
DATE
INSPECTOR
FINAL GAS
DATE _
INSPECTOR