51113 /r / `/��V l'- �t 1�je 41 r'1CJt 11, l -r-"Y.? LOT NO.
NO. STREET
z APPLICATION FOR BUILDING PERMIT
sa
r CITY OF CUPERTINO
oa / Sanitary No.
i LL Date /Z3 196? Permit No.
ro
�. W - Application is hereby made for a permit to
o �
i a story Type u-)U A c,l�r,k . Building
< w
to be occupied only as on J L4j 14
0 o in accordance with Plans, Specifications and Plot-Plan filed herewith.
"; Estimated Value of Improvements,$ t) Fee$
zJ It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
Z all other laws applicable to the construction, locatiN, and use of buildings within the City of
O Cupertino will be complied with.
3 < Owner a)1170 (�'YI%r,n ��C2nn:., • ddress
W a By 4T"`L— 'Address
Phone - I
_u
i o 0. Approved ele
State Licens BUILDING INSPECTOR
RECORD OF INSPECTION APPROVALS
FOUNDATION I
DATE INSPECTOR
UNDERFLOOR
DATE INSPECTOR
FRAME
DATE INSPECTOR
LATH and PLASTER
DATE. INSPECTOR
FINAL BLDG. j
DATE INSPECTOR
FINAL ELEC. j
DATE INSPECTOR
FINAL PLBG. j
DATE INSPECTOR
FINAL GAS
DATE INSPECTOR