1620 (3) No.. NO. l .
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APPLIC N. BUILDING PERMIT
RRR 11 , 4 �UPF TINO � f r
Date � �qg,5 Permit No.
it to
pplted�ib A Is ebf y made fora p1elrim
<906m_story,Type Building
at.
to be occupied onlv as�
in accordance with'Plans, Specificatio 0 Plot-Plan filed herewith. t-�y
N
Estimated Value oPIrriprovements, $ I - Fee
It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
all other laws applicable to [he construction, location, and use of buildings within the City of
•; �j. Cupertino will be complied with.
Owner G!/L � l�tli S.�s � .. Address
L ; m , . !
,r} Jp 4: -.c 'e7 55
a7 _ Address
CONTRACTOR, AGENT
Phone f L�/ %�/ Approve
BUILDING INSPECTOR
F ON APPRCV
F UNDATION
DAT / I IN PE OR
FRAME _7
ATG N GCTO
LATH and PLASTER • • _
^DATE 1 NSPRCTOR
FINAL BLDGLZ 1A
DATA IN
FINAL ELEC. 1 c3
DATE INSPECTOR.
'FINAL PLBG
DATE INSPECTOR
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FINAL GAS m`i
r3yK �DATE�^;A. } INSPP.CTOR
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CERTIFICATE OF COiO
MPLETIN r`
BUILDING INSPECTOR S -OFFICE
CITY.,OF OUPERTINO.;K
3 1
The Build J --
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r x Has(Been (. om leted I or Use s Y ..+.:. '�•>_1' r.
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102 4/61-500
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