2141 (2) LOT NO.
NO: STR t!T*
z < AP C. , FOR BUILDING PERMIT ,
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°' CIT\Y-OP CUPERTINO
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it, ate
w�t boa,
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LL Appllcatiolris h(ereby made fora p it to
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aN a �sl �. 'story;`T �tn'•" ' a12 QBtiddin
to be occupied only as st
oo in accordance with Plans, Specificatio nd Plot-Plan filed'herewith. )
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Estimated Value of Improvements, Fee$ `
o J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
z all other laws a licable to the construction, location, and use of buildings within the City of
0 Cupertin w' I.be mpli fd tvt
3 m. Owner ""'�` -�"'^"�"` Address'�f "7' /�r
Address r (}
a,U. phone ( Approved �_ / r
State-License '1 t BUILDING INSPECTOR/
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RECORD OF INSPECTION',APPROVALS
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DATE INSPY.CTOR'4`
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DATE INSPECTOR
FINAL ELEC. .
1 •• - 1 '� , DATE - INSPECTOR
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DATE y` INSPECTOR i
9 FINAL GAS
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