1131 (2) LOT NO._
No.
STEL
APP.LI��4Y� IOPI�FOR '.BUILDING PERMIT
�+T at 1
Th, .C! OF CUPERTINO
Date_ 4 to 95� P unit No. Ila
0� /
Application is'fiermy made'fr-a{hermit to
a— -5goryE1j+19eE �Q - Building
at
to be occupied only as
in accordance with Plans„Specifications and Plot-P n I�wherewith. .v
Estimated Value oUrnpiovements, C9Pce$ A5
It is hereby�ag ed that the requirements of the Cupertino Building and Zoning Ordinances and
$ all other law--applicable t fhe construction, location, and use of buildings in the City of
;-j Cuperti OX-111 he complied ith.
v
�^ Owner .� Address
n -
By Address
Phone G�
�CRAG'J'OR, AGENT Approve
-3-1 (( YYAA((J7
OUILOING INSPECTOR
-RECOR INSPECTION APPROVALS
FOUNDATION
DATE INSPECTOR
FRAME
DATE INSPECTOR
LATH and PL&STER
D TE INSPECTOR
FINAL BLDG.
D E INSPECTOR
FINAL ELEC. '
pA� INSPECTOR
PINAL PLBG.
DATE INSPECTOR
^FINAL GAS
./ DATE INSPECTOR
r .
._ . . I am•�.... C.c!yt
.T, the undersigned de herebj certiE'y that 1/
the owner an ccupant of the single family dce3iing,. t
for which I am making
application to do 4 ,ork as a home ovmer.
I also c
LGer
��tify that I will not hire any non_l.icensed
G � or contractor, butZ111this work ysel£,
TELEPhOiVE i•RJMBER _ SI .. TURE