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2193 (2) LOT NO, NO. STR[ET z APPLIC,�TI�C W-bll BUILDING PERMIT s ITYs OF 3� CUP\ ERTINO x- \� Sanitary No. W o Done 196_ Permit No. r 3, o Application is hereby made r•a gerfnit t aa TC//� to a story,TY9e' � Building a r to be occupied only as n 0 o in accordance with Plans, pecifications and Plot filed herewith. �•� Estimated Value of Improvements,$ . 7 L/!! err+ Fee$ 1.!5- 0 q z J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and j z all other laws applicable to the construction, location, and use of buildings within the City of o Cupertino wilLbe complied wh. ,, Q 3 F - aO �� �� .,,-� Address Gti(S`�4/�`� •. wne . . W a By Q Address a U Phone9.2_ pproved - A State License LDING INSPECTOR RECORD OF INSPECTI N APPROVALS FOUNDATION DATEt INSPECTOR UNDERFLOOR a DAT 1'. INSPECTOR FRAME nnrr: INSPECTOR ' LATH and PLASTER >?4& ODATE� INSPECTOR FINAL BLDG-J4 INSPECTOR FINAL ELEC. DATE INSPECTOR FINAL PLBG. DATE INSPECTOR FINAL GAS DATE INSPECTOR "h