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W ETINUG ltc QN FOR BUILDING PERMIT
r ITY OF CUPERTINO
W LL
0 , SaIItt'r\NO.
MUTSa
u Ian 196_ PermikAl ._ I
LL Application is hereby made for a permitto
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i to a story,Type t � 1'2Building
to be occupied only as �
0 o in accordance with Plans, Specifications and Plot-Plan d her-L-4C.^
I ; Estimated Value of Improvements, $ C% Fee$ —17A,to t eci_
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 o Cupertino will be-c,ompiied with.
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Owner Address / f9 ` *�
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W z
a By Address
U Phone °Z'–3 77 - Approve U �t
State License O277-�J O '� BUILDING INSPECT R
RECORD OF INSPECTION APPROVALS
FOUNDATION _-
DATE INSPECTOR
UNDERFLOOR
DATE INSPECTOR
FRAME
DATE INSPECTOR
LATH and PLASTER
DATE INSPECTOR
FINAL BLDG.
DATE INSPECTOR
FINAL ELEC.
DATE INSPECTOR
FINAL PLBG.
DATE INSPECTOR
FINAL GAS
DATE. INSPECTOR