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�T NO. V
- NO r. STt£ET "
APPLICATION FOR BUILDING PERMIT
DEC �9�? �Mk OF' 0VPERTINO
Sanitary No. c:97
Date t O j 19fiY mit No. 5
C"��lic�tlon is heE�b hti~aH�'%r a pewolko
a f story, Type __24j
Building
in accordance with Plans,a l��iiiins and Plot -Plan filed herewith. cr-�
6 P
Estimated Value of Improve nts, ecyo Fee $
It is hereby agreed that the requirements of the Cuperti o Building and Zoning
t�Ordinances
sKand
Cupertino
laws applicable to the construction, location, FRAIVC�' b �Lb1':�t't N0 CO
Cu ert�no will be 'c'omplied lied with. C
Owner Add UE
By /I
Phone y d'— 0'-3 a
State License L Fly '7
Addres
Approved
BUILDING INSPECTOR
RECORD OF INSPECTION APPROVALS
FOUNDATION cf,44. a ---
INSPECTOR
UNDERFLOOR
DATE -� �� INSPECTOR
FRAME
�LATdPLASTFR
FINAL BLDG.
FINAL ELEC.
FINAL PLBG.
FINAL GAS
-3
DATE
9-j6- ?
DATE INSPECTOR
�2-�-11