2075 (2) NO. S2k,BT
f APPLICATION FOR BUILDING PERM
r o Rae0�.E, OF CUPFRTINO
O a Sanitary No.
3u '/ QEC
i a Date 11,96_ Permit No.
a o Appligatjon,{S�hcrc ;nade for a per it to /S.40-e. ,
°
ato< I I J u (T 7 �pY�
a story, ! Building
to be occupied only as
4
o in accordance with Plans, SP ecificatioanot-P
ns d Pllan filed herewith.
0 _ O (7
� ; Intimated Value of Improvements, $� Fee$
oa
z J It is her y agreed that the requirements of the Cupertino Building and Zoning Ordinances and
J z all other la s applies e to the amstruRion, location, and use of buildings within the City of
O Cupertino I be comp i d with.
3 � I
- Owne I Address
W
a By Address_
<V Phone W- 1> lJ 7
ZZ pq / Approve
.State Ll cense 1-5—.31 O / X3 • BUILDING INSPECTOR
Q RECORD OF IN PECTIO APPROVALS
FOUNDATION 7
DATE. INSPECTOR
UNDFRFLOOR
.�Drn1�n� � INSPECTOR
I'RAME !� �-p 3
DATE INS PEC9 OR
LATH and PLASTER
DATE INSPECTOR
FINAL BLDG.
DATE INSPECTOR
FINAL ELEC.
DATE INSPECTOR
FINAL PLBG.
DATE INSPECTOR
FINAL GAS �-
DATE. INSPECTOR