495 _./7)/W
Nly. ST 'T
P TION FOR BUILDING PERMIT
o OF CUPERTINO
Dat¢ So - 195_ Permit No. /s^
•1 wou
-Application is hereby made for a permit t 'e4sL.-�
a story Ty[eI1T1Aif1�—1 Building
�o_bnll_7 . _
at _ 1
to be occupied only as l J
in accordance with Plans, Sped cations and Plot-Plan filed herewith.
Estimated Value of Improvements,$ ��• n O Fee$ O D
H
It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
all other laws applicable to the construction, location, and use of buildings within the City of
Cupertino w'11 be complied with.
5 Owner 2 1 Address
yea Q •
By d Addressf
CONTRACTOR, AGENT
Phone 5` • C. Approve
BUILDING INSPECTOR
RECORD OF INS PECTI _APPROVALS
FOUNDATION
THJ INSPECTOR
FRAME
DATE INSPECTOR
LATH and PLASTER
ATE INSPECTOR
FINAL BLDG.
TE INSPECTOR
FINAL ELEC.
D. INSPECTOR
FINAL PLBG.
DATE .INSPECTOR
FINAL GAS
DATE INSPECTOR
I i