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2509 (4)
NO spm DISL CH/��RGE/,' CITY OF CUFF 'O v) rr�faro Z&FICE �j. Date . ........ .._. ............-.._-- - -'--.... 1�. - Permit No J To ..... .. ..... ... .. .. ... .__. ... ---- -. ..._ ._ ...._. Address _ ...QaT _ ....... _ .. .. �_...:. .. �&( M / Reason .... .._. _ .. .. -am ..:_-(�-� ..... .� -..... _.._...... ---__..... ---..... ._..... - _-........_:: . . -;.__.._......... __........................._. II Vin.................... ..... OB .....-----�----..... .._.---_....... ..... .. .............. - ..._... ._ J Amount S . ..r.... Signed ............ - QCERTIFICATE ' 00,"I C6MPLETI6PI. V> BUILDING INSPE OR'S OFFICE CITY OF CUPERTINO Date.............1:......�.._ -----.-.:...�!--, 19t, Building Permit No: ,.. �,..... - l\ The Building Locate&�at ..)..L-;._,�—.-a�,. iS.+..... t-. '�, -• . .. Owned by ..------ n ;r`(ComPleted) e ' Has Been``�,',,..,..(Altered)...--^-'F fuse As: ..Ly.-',' .. ....-- ---- .............. I _ W ---------------- ....................................................... - - ......:_.------- --- .............. .............:....................... ------------------------------------------------------- j� -� -.. ............ ---------- ----- -- ------ .. � BUILDING INS ECT R 102 7/63-500.