1863 a09/z— l / I•(� LOT NO
NU. s EE
® APS LI ATTI!�ION� OR BUILDING PERMIT
C.I P CUPERTINO
Date BL r it No. _/ C S5
Application i(s�hereb F made for a a iit t
a rt-tY r: oil
s ry,Vylv Building
at
to be occupied only as 1�L�
in accordance with Plans, Specificatio nd�ppP�lotil_" filed herewith. 0,0
Estimated Value of Improvements,$��LiJ — Pee$
v
It is hereby agrJd that the requirements of the Cupertino Building and Zoning Ordinances and
all other laws .¢p{]cable to the construction, location, and use of buildings within the City of
rj Cupertino will b mplied wi S
1 Owner_ Address
v
By Address
tf
CON AC OR, AG t' T
Phone. Z -- Approved
BUILDING INSPECTOR
RECORD OF INSPECTION APPROVALS
FOUNDATION
DATE INSPECTOR
FRAME
DATE INSPECTOR
LATH and PLASTER
DATE INSPECTOR
FINAL BLDG. &AA
DAT INSPECTOR
FINAL ELEC.
DATE INSPECTOR
FINAL PLBG.
DATE INSPECTOR
FINAL GAS
L
INSPECTOR
_ I, ,the undersigned do hereby certify that
I am the owner and occupa o single
family dwelling at pqi� ��2fl
fwhich I am making application to do
work as a homeowner.
a so certi y hat I will not hire any . .
non-licensede. or contractor,
but will do thigrwork myself.
I ,X/
PHO�NEjNUMBER Np ~ g