100/0-26o �ql6ll l y 'r9
LOT NO.
NO. STREET.
w 2 ® APPLIMTI IN FOR BUILDING . PERMIT
E�
OF CUP TING
3NAV 7 fi3 Sanitary Ira
i a Date f ' 2 196 - ermit No. rwy
°
LL w A' cats is lie}' made for^a ermit to
o
i In a story, TYP°'�(�Bud tng
to be occupied only
0 o in accordance with Plans, Specifications and Plot -Plan filed herewith.
1- 3 Estimated Value of Improvements, $ ��d � Fee $
oa
z J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
z all other laws applicable to the construction, location, and use of buildings within the City'
o Cupertino will be complied with. /7
3 a Lf/E7t_S ,t%e�0 fill /0 240 #161141 Y
Owner Address
/0
By . A% C ' Address COA/ 4--
` 0 Phone��?i --37L;7--,' Ao°roved -IGC
State License BlitebTN° INSPECTOR /- \
RECORD OF INSPECTION APPROVALS
FOUNDATION
UNDERFLOOR
FRAME
LATH and
FINAL BLI
FINAL ELF
DATE INSPECTOR
DATE INSPECTOR
FINAL PLBG.
DATE INSPECTOR
DATE INSPECTOR
FINAL GAS
-DATE INSPECTOR