595 (2) LOT NO
NO. S REE T
PP TO +FOR BUILDING PERMIT
UPERTINO
Date + Permit N0. •r��
Application is hereby made for a permit to ���C�•
a C1 St TY�I(� rPafi. Building
at
to be occupied only as /A°//P2�e%r����l f4.(�i•
in accordance with Plans, Specifications and Plot-Plan filed herewith.
uEstimated Value of Improvements,$ ,�� Pee$ n21 6-0
a It is hereby agreed that the requirements of,thF Cupertino Building and'Zoning Ordinances and
all other laws applicable to the construction, cation, and use of buildings within the City of
Cupertino will b oin ied with.
�n
Address /
Owner119X7,0
By vSiS'f• _ Address '
//��
CONTRACTOR, AGENT
Phone'Ag l' - 7.1', Approved
BUILDING INSPECTOR
RECORD OF INSPECTION APPROVALS
FOUNDATION
DATE INSPECTOR
e
FRAME
DATE INSPECTOR
LATH and PLAST i}
INS _
er L,✓�/� DAY'R INSPECTOR
�
FINAL--$LD�L - 7 Cw-f�(E�'
INSPECTOR
FINAL ELEC.
DATE INSPECTOR
FINAL PLBG.
DATE INSPECTOR
FINAL GAS
' DATE INSYECT00. ,
2 I,, ihe,;.ur:der. siEned, do hers'by c rt'£y that I am
ti d
0. 4
^the ,otmer and occupant .o£ the si ¢:1e ? a; ply_dwelling at
„f£ow ich I am m'akirg
j ,
apnlicaticn, to do QldA-j�Z"' , . work as a,;home owner.
I also certify that I will not hire any non-licensed
or contractor, but will do this work n &sel£' .,
TEL�PE01'dL NITH3LR' `t;" ' SIGALViU? /✓