1709 (2) n 3j 6 ,
NO f.A
® APPLICATION 1O UILDIIdG PERMIT
MAY 14 19E8T c c .hTINO
Date TT��// ��[[ {{��pp[[ppTT 195_ Pe mit No...zo
AplQ1 n iflFjeb�JirfRFMR 1 el
a l story,Type Building
at U
to be occupied only as
in accordance with Plans, S it ations a d Plot-Plan filed herewith.
u Estimated Value of Improvements, $ QQ ,...,,�;trPee'$ �
v It is hereby agreed that the requirements of the Cupertino Building and Zoning Ord, ces nF1.
all -other laws applicable to the construction, location, and use of buildings within the ' of„Tt "
Cupertino will be complied wi[�Atiy,�\� 1 � • i '
Owne cT. Address
By Address ` c^
C TRACTOR, AGENT
•gip:l' s� `�;_
Phone Approve S;
Out DING INSPECTOW.j, �=
Tj, llpU
i `v
ti
RECORD OF INSPECTION APPROVALS
FOUNDATION —
DATE INSPECTOR
FRAME
DATE INSPECTOR
LATH and PLASTER _
INS PI{C'1'Olt
FINAL BLDG. �l/j�—\�
DAT6 INSPECTOR
FINAL ELEC.
DATE INSPECTOR
FINAL PLBG. .
DATE INSPECTOR
T• FINAL GAS' I }
4 DATE .i:' INSPrcTOR
, . .. ', the undersigned $o ereby certify that
I am the owner and occ pant e
at ' 3,
fo which I am mak-i g application to do
rk as a •"»eowner.
I also certify hat I w' ll not hire any
non-licensed or contractor,
but will do this work myself.
TELEPHONE NUMBER SIGNATURE— I