1133 (2) /D LUT NO.
NO. STREET
P BUILDING PERMIT
CITY UPERTINO
llate _ Permit No.
r
Application is hereby made fo a ermit to
a �'/� stoTy �
Building
at
O
to be occupied only as
in accordance with P ans, S ificat�iqVqs and Plot-Plan filed hell
erewith. Q�
Estimated Value of Improvemenfs,$l: C o-� Fee$ vO�r�`6
v
c 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
;.j Cupertino will be complied with.
v
Owne C• Address g50 V l_
n
lQQ/J� BI�l�PCONnA Address
�AGENT
�.3 lPhone_ y`�' _ ApprovedI i BUILDING INSPECTOR
X
RECORD OF INSPECT APPROVALS
FOUNDATION
DATE INSPECTOR
FRAME
DATE INSPECTOR
LATH and PLASTER 1
TE CTOR
FINAL BLDG. j l
DATE INSPECTOR
FINAL ELEC. 1
DATE INSPECTOR
FINAL PLBG.
DATE INSPECTOR
FINAL GAS
DATE INSPECTOR