208 / V O V • LOT NO.
NO. STREET
I N �
z z APPLICATI FOR BUILDING PERMIT
Ea
0 CITY OF CUPF.RTINO
o a Sanitary No.
5 0y,, p
i Date�2' 196Y Permit No. �d
a
`o r Application is hereby ade for a permit to
<
i N a story,T – Building
< w
W I to be occupied only as
0 'o in accordance with Plans, ecificatio ,andel Pl^ot-0� filed herewith. L / goo
� ; Estimated Value of Improvements, $O�o Fez$ T
z J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
J Z all other laws applicable to thction, locatiop, and use of buildings within the City of
O Cupertino will be complied with.
3i
_ a Owner�({i2P2 ,tJ o ✓ q l>/y Address 4 O �
W a By s .Cc/ Atkdk6��r
<U Phon SC' V — Approved �sy
State License BUILDING INSPECTOR
RECORD OF INSPECTION APPROVALS
FOUNDATION
DATE INSPECTOR
UNDERFLOOR
DATE INSPECTOR
FRAME
DATE INSPECTOR
LATH and PLASTER
DATE INSPECTOR
FINAL BLDG.
DATE INSPECTOR
FINAL ELEC.
DATE INSPECTOR
FINAL PLBG.
DATE INSPECTOR
FINAL GAS Adlbk
DATE INSPECTOR