2895 /a / / �� `� • — LOT NO.
NO. STREET
w APPLICATION FOR BUILDING PERMIT
E _
r o CITY OF CUPF.RTINO
0 LL
o � Sanitary No.
5Up
i o Date '� 196 Permit No. O
`o W Application is hereby made for a permit t
=in a__/_-sterf,Type Building
W (�
to be occupied only as _ /t Y 01�✓
oo in accordance with Plans, Specifications and Plot-Plan filed herewith.
> N ��
Estimated Value of Improvements, $ O p U O Fez a�
zJ It is hereby agreed that the requirements of the Cupertino Building and Zoning O mances and
J z all other laws applicable to the construction, locatio and use of buildings within the City of
o Cupertino wI be complied h.
_ N �Owne Address
W z
V W xBy AddressI _ 42
tl<0 hon Approved
❑ILDIN 'INSPECTOR
a State Licens
RECORD OF INSPECTION APPROVALS
FOUNDATION
DATE. INSPECTOR
UNDERFLOOR
DATE INSPECTOR
FRAME.
DATE INSPECTOR
,-tAd PLASTER 17
FINALL BLDZ .
DATE INSPE OR �
FINAL ELEC.
DATE INSPECTOR
FINAL PLBG.
DATE INSPECTOR
FINAL GAS -T
DATE INSPECTOR