428 LOT NO.
NO. STREET
wt$PLTION FOR BUILDING PERMIT
I o ff1 � ' OF CUPERTINO
rf
o a �1/ Sanitary No.
5 < / a
i Dat r N� 19 �196� Permit No.
ro p
o r Application is hereby made for a permit to
U) a CITY OF Std l5«.e Building
ar to be occupied only as____ c/Q Sc T
0 o in accordance with Plans, Specifications and Plot-Plan filed herewith.
> m /OD =
Estimated Value of Improvements,$ Fec S
iJ It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
* i all other laws applicable to the construction, locatiop, and use of buildings within the City of
d G Cupertm will be complied with.
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_ N Owner TZ — CQAq'c Address02
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BUILDINGdNPECTOState License ISSRr S
RECORD OF INSPECTION APPROVALS
FOUNDATION
DATE INSPECTOR
UNDERFLOOR
DATE INSPFCTOR
FRAME
DATE INSPECTOR
LATH and PLASTER
DATE INSPECTOR
FINAL BLDG.
DATE INSPECTOR
FINAL ELEC.
DATE INSPECTOR
FINAL PLBG.
DATE INSPECTOR
FINAL GAS
DATE INSPFCTOR