1968 Vi tl3t
NO. STREET
APP t I - OR BUILDING PERMIT
OF CUPERTINO
Date n 195_ Permit
Application is hereby made fora,p8rmit to
a ���t�story,Type &X%— �O ' �o t X L pu,Id,,g
at
to be occupied only as — 1
in accordance with Plans, Specificati n an�l Plot-Pla fled herewith,
Estimated Value of Improvements,$ Fee$�
It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and I
a all other laws applicable to the construction, location, and use of buildings within the City or I)
Cupertino will be complied with.
v� Owners 7�i!I /'. �i'1__= f-c✓'� Address - f
By Address BGG ] 'i l
CONTRACTOR, AGENT
PhoneX Approved —
• BUILDING INSPECTOR ,
i RECORD OF INS N PPROVALS
FOUNDATION
' DATE V NSPECTOR
FRAME 4
{,,/:� cc / �Cp DATE INSPECTOR
I.ATHs _� PI.ASTERR
DATE INSPECTOR
q FINAL BLDG.
{ DATE p INSPECTOR
FINAL ELEC.
i DATE INSPECTOR
FINAL PLBG. ^
DATE INSPECTOR
f FINAL GAS
DATE INSPFCFOR
1
i
I, the undersigned \ by c rtify t at
I am the ov:ner and occ �t o tYi� sin le
family dwelling at � g
fq� hich I am makingQ
cation to do
A2 �.1�'e wi rk as a homeowner.
I a so c rti y^tha I wgl not hire any .
non-licensed {Z- o,j e qr contractor,
but will do this w' r myself.
TELEPHONE NUMBER SIGNATJ
�a+emiwn,an _