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Z 03LOT NO.
NO. STREET
wAPPLICATION FOR BUILDING PERMIT
EX
r O CITY OF CUPERTINO
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o Sanrtary 1`0.
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i LL Date 196_ Permit No
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LL W pplieation a hereby ma Fora ermit to roo
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n ntorry,Type, Building
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L be o„cr0upi d only4ai ' t f�
0 0 m accordance J.wit}i`Plans, Specifications and Plo49an filed her with.
Estimated Value of Improvements, $ eo Fee S
o < C11 v. r I� y ill[) E�I�" .
z J It s hereby a t tha the equmments of the Cupertino Building and Zoning Ordinances and
z all her laws applicable to ft elcon i location, and use of buildings within the City of
2 0 Cup t' wil mplifd wi
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< 0 Phone �SZ�'�6�� Approved IDi-i-TAn�t n nrnt�rn.-�I
�� State Licenses-����++ ' _ BUILDING INSPECTOR .
RECORD OF INSPECTION APPROVALS
FOUNDATION
DATE. INSPECTOR
UNDERFLOOR
DATE INSPECTOR
FRAME
DATE INSPECTOR
LATH and PLASTER I
DATE INSPECTOR
FINAL BLDG.
DATE INSPECTOR
FINAL ELEC.
DATE. INSPECTOR
FINAL PLBG. _
DATE INSPECTOR
I
FINAL GAS
DATE _ INSPECTOR