1812 • CITY OF. CUPERTINO
CITY OF. CUPERTINO JA 1981
APPLICATION FOR RESIDENTIAL BUILDING PERMIT PERMIT NUMBER
AND FOR APPLICANT TO FILL IN
CERTIFICATE OF OCCUPANCY
BUILDING INSPECTION DIVISION STREET ADDRESS OF PROD •
V � .Y�........U&/'O,o ...Re!..................
x • • • • Legal D/crip..Q.tion: Tract.... .._......._ Block..... . .. Lot...... .... ..........
Description of Work:
Plane Received By ._. C -✓Z- � pT-. .��
y....................................................Date .........................
........................................................................................................................
REO.: Pians.... Survey.... Calcs: Struc..... Energy.... Elect..... Mach... tat Struct. Improvement on Parcel: Yes.... No... Area of Bldg...............
Plans Checked By..................... .. Date ... .. .-. . . v Separate Structure............ or Addition/Alter tion to Exist Idg...........
Application Approved By........._. .s.... _._r..._Date ../../.7 .��..r..- No. of Stories... ...._...... Use of Bullgg .�.. hv.6C..f.