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100015e t I(At,) LOT NO. ST EET APPLICATION FOR BUILDING PERMIT CITY OF CUPERTINO Sanitary No. p010 Dat_____/ 196— Permit No. i ®a a Der Application is hereby made for a permiygo�C�� a (79 n)G. story, Type 1-5— Ibo��-©t Lea I\ Building to be occupied only as Z o r X so C) est L tp t2 0o M in accordance with Plans, Specifications sand ,P,,,,l,ot Plot -Plan filed herewith. Estimated Value of Improvements, $�Fee $ It is here y agreed that the requirements of the Cupertino Building and Zoning Ordinances and all other la .i applicabl to the construction, location, and use of buildings within the City of Cupertino wi a compli with. Owner By Phone State License 11 RECORD OF INSPECTION APPROVALS FOUNDATION I _ UNDERFLOOR FRAME LATH and PLASTER FINAL BLDG. FINAL ELEC. FINAL PLBG. FINAL GAS DATE. INSPECTOR DATE INSPFCTOR DATE. INSPECTOR DATE INSPECTOR DATE INSPECTOR DATE INSPECTOR DATE DATE INSPECTOR INSPECTOR