NO PERMIT NUMBER (2) r .
21581 Columbus Afire. }, (Pool)
NO. STREET `1 LOT NO.
.56
CIY'Y W CUPERTINO
APPiICATLON FOR BUILDING PERMIT
SANITARY NO.
FILE NO. 51.167
DATE 6/1/76 19_
Application is hereby made for a permit to
Cnnckrunt a -- story,type I — Gunite
to be occupied only as Rwi Tmni ng Pool (16't X 12' )
in accordance with plot plan,plans and specification filed herewith.
ESTIMATED VALUE OF IMPROVEMENTS $ 8,000
FEE$ 1111.00 PLAN CHECK$ 22.00 -
OWNER Prhard T-o"Stnn _ADDRESS
• PHONE P55-993P
CONTR, Hawai i Pin Pnn1 ADDRESS 5847 Camden Ave.
PHONE 377-3250 STATE LICENSE 140-1 P7n7
APPROVED .T mea H. isk/h
BUILDING INSPECTION RECORD
DATE INSPECTOR DATE INSPECTOR
FOUNDATION FLOOR STEEL
PRE-GUNITE RAME
BOND BEAMS LATH
WALLBOARDS- 0.8 EXT.
FIREWALLS
MEMBRANE LANDSCAPING
F.M.O. INSPECTION
FINAL BLDG. .
UNDER-FLOOR
TIEDOWNS -MISC-
DIAPHRAMS
i
MOORE BUSINESS rORMS INC LI.