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APPLIC FOR- BUILDING PERMIT
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IIV ' 196_ Permit No
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`o TY OF CUPER
W Application is hereby made for a permit to S
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r ; Estimated Value of Improvements, $�0 O Fee$ 60 A C)
i J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
J Z all other laws applicable to the construction, IocatioQ, and use of buildings within the City of
j O Cupertino will be com i d h.
3 a Owner ' ' Address
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By Addre r
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$tat[ Licens 6� B 11, ING INSPECTOR ��
RECORD OF -INSPECTIONNj�APPROVALS
FOUNDATION
DATE. INSPECTOR
UNDERFLOOR 11-1,/
DATE (� INSPECTOR
FRAME /)
DATE INSPECTOR
LATH 'd PLASTER // - T
DATE INSPECTOR
FINAL BLDG.
DAT INSPECTOR
FINAL ELEC. '
ATB INSPECTOR -
FINAL PLBG. I
ATR INSPECTOR
FINAL GAS
D kTE INSPECTOR