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IFEB 24 PgaS oOR BUILDING PERMIT
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O < Itary No.
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0 �j�ae1 fU 196E- er o. ,
4 Application is hereby made for a permit to C
o <
z N a story,Type C 0'w**'V) Building
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ito be occupied only as ALF Sr/r�
o `o in accordance with Plans, Specifications and Plot-Plan filed herewith. r �'
F ; Estimated Value of Improvements, S 0200-00 Fee E
iJ It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
J i all other laws applicable to the construction, locatiop, and use of buildings within the City of
o Cupertino will be complied with.
3 /tCa4r C O!L C� • 7
Owner p Address,133
W "�' BnPcl ccO4 SIA" .9�62VrCC- Address
a a
` 0 Phon 0'7 Approved
- State License - emimrac wsaec oa
RECORD OF INSPECTION APPROVALS
FOUNDATION
DATE. INSPECTOR
UNDERFLOOR j
DATE. INSPECTOR
FRAME
DATE: INSPECTOR
LATH and PLASTER
DATE. "' INSPECTOR
FINAL BLDG. j
DATE INSPECTOR
FINAL ELEC.
DATE INSPECTOR
FINAL PLBG.
DATE INSPECTOR -
FINAL GAS
DATE INSPECTOR