199 NO. STREET 17
W APPLICATION FOR BUILDI G PERMIT
E (C
g CITY OF CUPERTINO
R _
0 ' Sanitary No.
SU
Date 196 ermit No.
0
`o r Application is hereby made fora rmtt
i N a story,T ng
cw
to be occupied only as t
o 'o in accordance with Plans, Specifications and PIo - la led herewith. SO
> ; Estimated Value of Improvements, $ 9, �' — Fee$
zJ It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
* Z all other laws applicable to the construction, location, and use of buildings within the City of
20 Cupertino will be complied with.
3Q
_ ,a Owner PL{ly Ai im SayI Address
W a By N(' Address 6
C,
0 Phone 2���f3 7 APProved
State LicenseING INSPECTOR
RECORD OF INSPECTION APPROVALS
FOUNDATION I
DATF. INSPECTOR
UNDERFLOOR
DATE INSPECTOR '
FRAME
DATE INSPECTOR '
LATH and PLASTER I
DATE INSPECTOR
FINAL BLDG. j
DATE INSPECTOR
FINAL ELEC.
DATF. INSPECTOR
FINAL PLBG. "
DATE INSPECTOR
FINAL GAS Adak
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