190 /eft 2i
l LOT NO.
NO. STREET
2 ] APPLICATION FOR BUIL tING PERMIT
c CITY OF CUPERTJ 0),v
Dat et't 195. I Permit No. L/
Application rely a eF r,, per i'to
a tpr�yy,�3P5 Building
1 Ip I rte.
at
to be occupie �n as f-
in accordance`d�ith Plans rSpeci kation/nd Plot-Plan filed herewith.
u Estimated Value of Improvements,$�f 7,- Fee$
u It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
all other laws applica a i the construction, 1 cation, and use buildin within the�Cit y of ry
Cupertino laws ,co led with. /t/ he
'J —C.c- c /�C
Ii Owner Address �`(%
By ww Address
ONTRACTOR, E T
Phone Approved
BUILDING INSPECTOR I
RECORD OF INSPECTION APPROVALS
FOUNDATION
���— —
TR INSP .TOR
FRAME
E IINSPOR
LATH and PLASTER ��
TR OR
FINAL BLDG.
DATE INSPECTOR
FINAL ELEC.
ATE INSPECTOR
FINAL PLBG.
DATE INSPECTOR
FINAL GAS 3
DATE - INSPECTOR
CE R T I F-1 �m"TE OF COMPLETION
B LDiNG WSPECTO 'S OFFla-
CITY or CU E INO
Date ........... M......... .................. 195.... ... Building Permit No.
............
The Building,Located at ......�.;.
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Owned by . 0
...... ......... .......... ............ ............
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His Been (Completid) For Use As: .................................
(.Altered) ..................................................
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BUILDING IN.SPECr'O'...R..........
102 2/59-250