223 LOT NO.
> r �
2 j S 5 AjPP sr IRCATIONfFOR BUILDING PERMIT
` CITY OF CUPERTINO
Date Permit No.
Applicitgis hereby
made or- permtC fo /�V� y
a .ary;1'F%Pe a Building
at ��// nn
to be occuple��dly ds'
in accordance with Plans, Specificat' ns pd _Plot-Plan ed herewith.
Estimated Value of Improvements, $ y�-.�� Fee$
It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
a all other laws applicable to the constructI, location, and use of Lauildinq within the gCity of
Cuper[ino}9j11 be m plied /J� / �`� 7
!�
v� OwnereLl el Address
1
By Address
/ Co TRACT , AGENT
Phone Approved- 7
� "I BUILDING INSPECTOR
7�i
RECORD" OF' INSPECTION -APPROVALS
/ � .1
FOUNDATION L-�jg�-
D E �� INSPECTOR
FRAME
rE -INSPECTOR ,
LATH and PLASTER
DATE INSPECTOR •
FINAL BLDG. - V
'
DATE INSPECTOR
FINAL ELEC.
DATE INSPECTOR '
FINAL PLBG.
D E INSPECTOR
FINAL GAS
DATE 1 INSPECTOR
CERTIFICATE` OF .C''OMPLk TION
BUILDINGINSPLCTOR'SOFFICE
CITY OP CUPLRTINO
bite . ...._._------ .Y`
' x................ � .' Idin,{ Permit No.
The Building Located-at .aFf-•,%:-s- ........._= '^'..•a'�°''. .�: - ..
-
Owned by ... . I,:
✓t ................. :n✓ s ,. +...........jr
.....
(Completed)
For
Has BeBeen („Altered) Use As a
- ................. ......................._. :....- - ..................... `
... ._ ._ ... .. ... _... -
..
...... .
. 1 ..�
BIJII.DING INSPF,CTnR' '-
102'2/59-250 •. y'