91 C c C tt i5T C{Z I "f W O TIER N0.
NO. STREET
a APPLICATION FOR BUIL ING PERMIT
{— y—
p ° PUT
J G� ill CUPERTINO
0 �^ �'�J '� Sanitary No.
Date t } 1 . Permit No.
4 Application is hereby made for a permit t
0 a r
i m St Cups, Buildina � g
aw r
w s to be occupied only as
r �
'o_ o in accordance with Plans, Spe ifications at d Plot-Plan filed herewith.
F3: Estimated Value of Improvements,$ate Fee E
oa
z 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, location, and use of buildin within the City of
d 0 Cup tin be complied Q��
3 Owner - 'Ka=4 Q ;�Address
w w tt .c
a a
/
/— r/
0 �
a Phone Approved
State License��7- BmL4G INSPECTOR
RECORD OF INSPECTION APPROVALS
FOUNDATION
DATE. INSPECTOR
UNDERFLOOR
DATE INSPECTOR
FRAME
DATE INSPECTOR
LATH and PLASTER
.DY`/ATE - INSPECTOR
FINAL BLDG.
DATE INSPECTOR
FINAL ELEC. �
DATE INSPECTOR
FINAL PLBG. . �.
DATE INSPECTOR
FINAL GAS
DATE. INSPECTOR