100021 (2) %Vw LOT No.
NO. STREET
w Z APPLICATION FO BUILDING PERMIT
r o CITY OF CUPERTINO
o �� EliSanitary No.
3 u f�L' @p
nl 196— Permit No.
o Ulipplication is hereby made.fit t�
i to a story,Type Building
< w
W ? to be occupied only as
o `o in accordance with Plans, Specifications PlotQ-P1 n filed herewith. 00
> ; Estimated Value of Improvements, S Fee$
iJ it is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
* Z all other laws applicable to the construction, locatiop, and use of buildings within the City of
j o Cupertln M be complied with
3 4 Owner Address
N
Q a By Address
< 0 Phone b - i 5 - Approved
Mate License— BUILDING INSPECTOR
RECORD OF INSPECTION APPROVALS
FOUNDATION I
DATE. INSPECTOR
UNDERFLOOR
DATE INSPECTOR
FRAME
DATE INSPFCTOR
LATH and PLASTER
DATE INSPECTOR
FINAL BLDG. j
DATE INSPECTOR
FINAL ELEC. j
DATE INSPECTOR
FINAL PLBG.
DATE INSPECTOR
FINAL GAS Admk
DATE. INSPECTOR