100021 /7S
LOT NO.
NO. STREET
w APPLICATION BUILDING PERMIT
E �
>: ° CITY OR CUPF.RTINO
o < A. S Sanitary No.
5U
1- t u' n 196_ P rmit No./O 0. (f -2/
o ' n{
o r Application is hereby in u -r a rmit to
a
i in a story,T e Building
a w
ito be occupied only as
0 o in accordance with Plans, Ifications andel Plloo-t�-P abfiled herewith. p p
> ; Estimated Value of Improvements,$ --4/t,1 uu Fee$
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 Cupertin ill be complied with.
3 Owne /) Address
— w
Z
By Address
° Phone 9 - r- 5 7 Approved
BUILDING INSPECTOR
State License
RECORD OF INSPECTION APPROVALS
FOUNDATION I
DATE INSPECTOR
UNDERFLOOR
DA'Z'E INSPFCTOR
FRAME
DATE INSPECTOR
LATH and PLASTER
DATE INSPECTOR
FINAL BLDG.
DATE INSPECTOR
FINAL ELEC.
DATE. INSPECTOR
FINAL PLBG.
DATE INSPECTOR
FINAL GAS
DATE. INSPECTOR