187 (2) • GC' /C" L7 tt -.c-Q-L L- LOT NO.
NO. STRp�T
2 1 5 5 A ;Lii CATION FOR BUILDING PERMIT
' CITY OF CUPERTINO
s
Date /1_ '
195 , Permit No. _
�
/ r(
AppL 4fio ,eieby:m ge.QKr a er t to /
r!
a rstor, .kel .y Building
at
to be occyp'ed�nl}I3
11r� II (� t
in accordance with Pans, Specificatio s a d Plot-Plan fil herewith.
u Estimated Value of Improvements,$�. Fee$
u It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
all other laws applicable to the construction, I ation, and use of buiLdings within the City of
"t Cupertino qµr/dyl�be co 'liIed with' J 7
� ✓v L /'Ci C.Lf 6 Ct V C/
,n Owner — r e, Address ..
a
AlIft Address
NTRACTORnG NT /
Phone, /V z n�/ , � Approved `�
BW mNG WSPRCTOR
RECORD OF INSPECTION APPROVALS
FOUNDATION 1
R INSPECT a
FRAME
/ATR INSPE To
LATH and PLASTER �`� I -
DATE INSPECTOR
FINAL BLDG _
,DATY' INSPECTOR
FINAL ELEC. n
Y/AT INSPECTOR
FINAL PLBG. I C4
ATR INSPECTOR
FINAL GAS
DATE INSPECTOR
�vk. I ,� • i '
CERTIFICATE OF 'C`OAApE�TION
BUILDING INSPECTOR'S OFFICE
I
CITY OF�+CUPERTINO
Date ....�.��..L/.�.n r .. ,195../_. Building Permit No.
The Building ocated'at .`�7✓f. ,J......... '•',`..'t"!�
s
Owned by ./.: /f ,r>,!r.: .L✓Wfr .....................
(Completed) ,
Has Been (.d�tecE11) For Use As: ........... —Yi �'!>'i.-;�............................
....._....... ..... ...........:..... ..._.. _..._..... ........ f
....................
RUILDING
102 2159-250 I INSPEC'rOR
4