100017 (3) 167
1023 LOT NO.
NO.
APPLICATION FOR BUILDIN RMIT�
N Q
Z
� CITY OF CUPERTINO
Y LL
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p J Sanitary l7o.
t
i LL Date l/ 196-(/ Permit No. J d t 17
r p
`o W Application is hereby made for a p t to ��C
i to a C�^A s= story,Type — Building
t
w1 q 11 � +
V
to be occupied only as z X I �Q 'Dae ARS
0 o in accordance with Plans, Specifications and Plot-Plan filed herewith. 60
F3 Estimated Value of Improvements, $ 2 r°p Fee$ 1
iJ It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
J Z all other laws applicable to the construction, location, and use of buildings within the City of
J O Cupertino will be complied with.
_ m< (G TC.,. .c,«[_�L Address
Owner /✓'
W a By Address
02
< 0 Phone J. —.3 G.5' Approved
State Licens BUILDING NSYECTOR
RECORD OF INSPECTION APPROVALS
FOUNDATION I
DATE INSPECTOR
UNDERFLOOR
DATE INSPECTOR
FRAME
DATE INSPFCTOR
LATH and PLASTER I
DATE INSPECTOR
FINAL BLDG.
DATE INSPECTOR
FINAL ELEC.
DATE INSPECTOR
FINAL PLBG. I
DATE INSPECTOR
FINAL GAS
DATE INSPECTOR