72 I.OT NO.
NO. EET
w iP .L CATION FOR BUILDING PERMIT
x o ® CITY OF CUPERTIN
� LL
0 J 1nlylr\' IYG..
3 ` a giUG 18 9
LL V11 YA QllcatibSt�'s�h I m�defor a ermit to
a to aCITTAtry, ype c Building
to be occupied only as SX n 0 J R V( C_/V
a
ii o in accordance with Plans, Specifications and PL4t flan filed herewith.
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F 3 Estimated Value of Improvements, $ .-"J Fee$_
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J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
J i all other laws applicable to the construction, location, and use of buildings within the City of
O Cupertino wi C-compli�'f_with
3 aXOwner •L"`,• !Address
N .{
W a KBy ,fi g Address•�"�J './/tib a
.a' ,ii Phone
•� S Z' Approved �
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State License BUILDING INSPECTOR
RECORD OF INSPECTION APPROVALS
FOUNDATION
DATE INSPECTOR
UNDERFLOOR
DATE INSPECTOR
FRAME
DATE INSPECTOR
LATH and PLASTER
D�E INSPECTOR
FINAL BLDG.
AEINSPECTOR
FINAL ELEC.
DATE INSPECTOR
FINAL PLBG.
DATE INSPECTOR
FINAL GAS
DATE INSPECTOR