BLD-2021-1742_Request for Permit ExtCITY OF
CUPERTINO REQUEST FOR PERMIT EXTENSION Please e-mail the completed form to permi teen ter@cu pertino. org
QS] Under Plan Review Process D Issued Permit
Building Address: _1_In_fi_ni_ti _lo�op __________ _ Pennit Nwnber: BLD-2021-1742
Owner Name: Apple ----------------------------
O w n er Address: ______________ Phone: _________ _
Contact Name: ----------------------------
E -mail Address: ____________ Phone: ____________ _
Reason(s) (please be specific): Requesting extentio n for plan review to continue with permit .
We are asking to extent plan review to obtain permit Yes No Approval: X □
Date: __ /_O_-�/�/_-_bv_L_3 __(CITY OF CUPERTINO USE ONLY) Expired Date: _12/21/2023 Fee:$ 243.00
Revised 7/25/2017