409 r n / Ila
`r NO. STREET
W PPLICATION FOR BUILDING PERMIT
99 � CITY OF CUPERTINO
o t �1/ 1� Sanitary No.
s� 4zo 9
F o pate /f4�D i"• � 196-7 Permit No.
o Application is hereby a fr a permit to
a
N ,0ITV ry.- 5't^� �� wilding
w
to be occupied onl
ii `o in accordance with Plan Specificati s and Plot-Plan filed herewith.
> 0 Estimated Value of Improvements, $ �e2 Fee$
i J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
* Z all other laws applicable to the construction, locatioq, and use of buildingy within the Gny of
0 Cupertino will be complied with. ,rJ-fP(o/(r �g`�`"S"r /
3 a OwneV•-'T��'e.n/G �"u Address Se
a a By�D-WA�Stron/ �QA/ Addr
us _
< 0 Phone S S Approve
State License BUILDING INSPECTOR
RECORD OF INSPECTION APPROVALS
FOUNDATION
DATE. INSPECTOR
UNDERFLOOR
DATE INSPECTOR
FRAME
DATE INSPECTOR
LATH and PLASTER
DATE INSPECTOR
FINAL BLDG.
DATE INSPECTOR
FINAL ELEC,
DATE INSPECTOR
FINAL PLBG.
DATE INSPECTOR
FINAL GAS
DATE. INSPECTOR