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aN r ee ( zo 0
w p IIIY/ APPLICA N FOR BUILDING PERMIT
o0 ° APR 211964 °TY or cuPExTINo SAO i�G
U
a i Sanitary No.
�9
= o Oy� Tr' 196-4—LPermit No. T�
o l�/ Application is hereby made for a permit to C041 e T,20L-� -
a
a N a 2 story,Type &AM v Q E'7 c c Building
to be occupied only asSroez'r -rt m �¢S I fl e ✓i p
0 o in accordance with Plans, Specifications and Plot-Plan filed herewith. 'q
"; Estimated Value of Improvements, $22 o�O Fee$ v
i J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
J Z all other laws applicable to the construction, location, and use of buildings within the City of
d o Cupertino will be complied wit 7.
3 < S/0 �I7�rTCfCOa 5v.
— 0 Owner e / e! _ Address
W By Address
a U Phone .$—S G
Approve
State License -3/0 6 S4— But
.6wc INSPP.CI'OR
gEC�ORD�DF INSPE • { APPROVALS
U
FONDATION CA
DATE INSPECTOR
UNDERFLOOR
PATE l/ INSPECTOR
FRAME
DATE / INSPECTOR
LATH h nd PLASTER T
DATE
INSPECTOR
FINAL BLDG. �1-�2—
DATE INSPECTOR
FINAL ELEC. 1.2
DATE. INSPECTOR
FINAL PLBG. /�
aDATE INSPECTOR
\FINAL GAS
Dnre � INsvecroa
V /