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= LL Date 196_ Xermit
4 (� T p Iop� or a per o C T'
oa lr� IVl�I�Uf LI\ ,9a F�l1 A,w
im a jD�ftiing
to be occupied only as ' x 4 a. ,�,lA�• �111,ti� U13-
in o in accordance with Plans, Specifications and PPI Plan filed herewith. I
F ; Estimated Value of Improvements,$�� Fee$ ! Z T
OJ It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
J z all other law applicable to the construction, location, and use of buildings within the City of
0 Cupertino wiI com d with.
3N Owner � �• Address
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State Licens if 87s Ae B ING INSPECTOR
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. j
DATE INSPECTOR
FINAL PLBG.
DATE INSPECTOR
FINAL GAS
DATE IN,SPFCTOR