417 2c3�t r $�cQ. �3�i
LOT NO.
NO. STREET
w ,7d APP}LIuCATION FOR BUILDING PERMIT
,\ �T='� rCITY OF CUPERTINO
a _ IL'!I Sanitary No.
n '
= a Date �v 13 195 196_ Permit No.
' o
o a rI��PPII IS�on�U}1 hereby
made
el for a permit to `
im a"®� story,Type1'�2 i\ �•, ASCIC� TA ilding,
to be occupied only as .� Y�.�pw�,� gpw�w��T=
0 o in accordance with Plans, Specifications aand_Plot-Plan filed herewith.
F3 Estimated Value of Improvements,$ QO� Fee$�
0 s
z J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
z all o her applicable �e�[he construction, location, and use of buildings within the City of
o C er❑no wil a complied It
3i
_ m Owner S Q {IIA�ss
a a By 'f v Address
of
4 ° Phon �
u Approv
State License —
RECORD OF INSPECTION APPROVALS
FOUNDATION
DATE: INSPECTOR
UNDERFLOOR
DATE INSPECTOR
FRAME
DATE INSPECTOR
LATH and PLASTER
DATE INSPECTOR
FINAL BLDG.
DATE INSPECTOR
FINAL ELEC.
DATE INSPECTOR
FINAL PLBG.
DATE INSPECTOR
FINAL GAS
DATE _ INSPECTOR