497LOT NO. -
NO. STREET !�
APPLICATION FOR BUILDING PERMIT
r.. --ft CITY OF CUPERTINO
j1f&E,Ps4ewbRSje frL permit
a story, Type J
at CIVAW�IPFRTItin
Permit No.__�—
trt
Building
to be occupied only as KZ-t,`y —
in accordance with Plans Specifications and Plot -P an filed herewith.
Estimated Value of Improvements, $ �* Fee � C' _
It is hereby agreed t4at 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 will be con3plied with.
Owner lj� _ ' a Address tea'
� l�
By + Address
CONTRACTOR, AGENT/ '
Phones �1- ° s S ` ' Approved ��t "�• �t Iti
BUILDING INSPECTOR
RECORD OF INSPECTION APPROVALS
FOUNDATION
DATE
INSPECTOR
FRAME
DA l'E
INSPECTOR
LATH and PLASTER
D TE INSPECTOR
FINAL BLDG.
DA /
INSPECTOR
FINAL ELEC.
J
DATE
INSPECTOR
FINAL PLBG.
DATE
INSPECTOR
FINAL GAS
DATE
INSPECTOR