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NO. �TREET
N a APPLICA�°lOt� F � BUILDING PERM9IT
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� ° CI'I'I' OF CUPER'I'INO
o � Sanitary No..
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W �. Date , 196_ �ermit No. �����
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o � Application is hereby made for a permit to �,����
a
z�n � st�y�Ty e "" � Building
a W ( v2��/ -v � ,
Q � to be occupied only as � b
0 0 �n accordance with Plans, Specifications a�d P t-Plan fil��erewith.
F3 Estimated Value of Improvements, $_���; .�� `' Fee$��r� /���`
z J It is hereby agreed that the requirements of the Cupertino Buildin� and Zoning Ordinances and
� Z a(1 other laws applicable to the construction, location, and use of buildin�s within the City of
� o Cupertino 11 be com lied with.
3 � . .�
– N Uwner -�° e 4�6�Fa � � �d+s'-� ' y',,.�Address ,
� a By� �''- �'�'�"�"--� `����-' Address �
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_� Phone Approved �' .� � '���✓_=ti'�
SYatC L1CCi1SP 1, BUILDING INSPECTOR �`
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�� RECORD OF INSPECTION APPROVALS ��.,�`' S�
�Y �'..
��.i 'y!'�S�` 's
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FOUNDATION � �
DATE INSPECTOR � E�'��
UNDERFLOOR �
DATE INSPECTOR
FRAME �
DAT& INSPECTOR
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LATH and PLASTER I
DATfi INSPECTOR
FINAL BLDG. �
DATB INSPECTOR
FINAL ELEC. �
DAT& INSPECI'OR
FINAL PLBG. �
DATB INSPECTOR
FINAL GAS
DATF. INSPF.CTOR