1908 (2) / LOT NO.
No , ' yt� EET
pppjjjyP'L T )N FOR BUILDING PERMIT
OF CUPERTINO
Date 195_ Pe
13 1 U IUV4 ID
Application is hereby made fora permit to
a CITY
st wilding
OF,,
at
v
to be occupied only as
in accordance with Plans, SpecificaL.tions and Plot, filed herewith.
u Estimated Value of Improvements,$ ,/z D ova Fee$ Gam`
It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
all other laws applicable to th construction, location, and use of buildings within the City of
Cupertino w' eca plied wilt -
Owner �ddress
By Address
CO TRACTOR AGENT
Phone 1 Approved (dam
BUILDING INSPECTOR
RECORD OF INSPECTION APPROVALS
FOUNDATION —
DATE INSPECTOR
FRAME (—
DATE INSPECTOR
LATH and PLASTER I— —
p INSPECTOR
FINAL BLDG. I—
D H INSPECTOR
FINAL ELEC. j
DATE INSPECTOR
FINAL PLBG.
DATEINSPECTOR
FINAL GAS 1
DATE INSPECTOR
11
I, the undersigned do herebyj, certify" that
I am the owner and occupant ' a sin�,le
family dwelling at //
for ich I am making app i ion to do
work as a homeowner.
a so certify a I will not hire any
non-licensed or contractor, iI
but will do thieKwork myself.
AA