418 a3r Sq�- CRt< �aoy
"-->.nT NO.
NO. STREET
W Z APPLICATION FOR BUILDING PERMIT
sM
r o CITY OF CUPFRTINO
Q LL
sSanitary !N
U
= LL Date 196_ Permit No.
A liar[��is herelU made for a permit I C
o ��
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4 W �j�j
i a P \�ty�Type� Q rA L �/��rr� Building
aw '�4/ UUT 77
a ; to be occupied'on yy", d
0 o in accordance with Plans;Specifications and PI o -Plan filed ewith.•
> N r� y. nC S OQ Fee S
Estimated V�aV�f rImprovements,
iJ It is hereby agreed)thati[hte requirements of the Cupertino Building and Zoning Ordinances and
J i all er laws p able tokhe cons uction, Iota and use of buildings within the City of
d 0 Cupe i o it
b e nplied with. y!/��
3 < Vf
_ � Owne •/
W By 7/ Address
a U Phone rzs 1 " G�� Approved
State License
����rHI111DING�rNSVF.CTOR' t
RECORD OF INSPECTION APPROVALS
FOUNDATION
DATE INSPECTOR
UNDERFLOOR
DA'I'S INSPECTOR
FRAME
DATE: INSPECTOR
LATH and PLASTER
DATE. INSPECTOR
FINAL BLDG.
DATE INSPECTOR
FINAL ELEC.
DATE INSPECTOR
FINAL PLBG.
DATE INSPECTOR
FINAL GAS --
DATA. INSPECTOR