1629U4
NO, _
® g4P" PL°IL' 3 R BUILDING PERMIT
A
PR 12196�,I CUPERTINO
Date 195_ � Peunit No: 16=;5S
Appli {9n �S reISV6E
a IIJJ h1 story, Type
at
to be occupied only a
in accordance with Plans, Speci ,
Estimated Value of Improvements,
Building
Fee $ 17 -
It
7
It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
all other laws applicable to the construction, location, and use of buildings within the City of
Cupertino will be complied with. A C-
0
(�
Own -' - �4.\\ Z�'1 Address\31�3ss c� "�C-0�5 'tll
By � — LCT N Address
CONTRACTOR, AGENT
Phone ' Approved
➢ ILDING INSPECTOR ,.
RECORD OF INSPECTION APPROVALS
1.
FOUNDATION
DATE
FRAME
DATE
LATH and PLASTER
DATE
FINAL BLDG.
DATE
FINAL ELEC.
DATE
'FINAL PLBG.
DATE
FINAL GAS
DATE'
INSPECTOR
INSPECTOR
INSPECTOR
INSPECTOR
INSPECTOR
- INSPECTOR
M1 �,
'IL•INSPECTOR