206 �Q / 3(8
u to.
NO. STREET
w z APPLICATION FOR A LIMING PERMIT
sa
IT—
° , OF CUPFRTINOa S ' S
anitary No. oe
—
CITY
OU:rt211,11e-7a
,l9G� ermitNo. Oi o , lyb/ Y u
`o a Application is hereby �e fur-,a perErIit to
iin a /�ITV .r
Q w Jf 1 1 l)t V..1rLl• 1 tl yl l '
to be occupied onl
00 in accordance with Pla Speci tons and Plot,4n filed herewith. ♦�
�' Inm
, Estimated Value of Improvee s, $��r��e Fee$ _
i J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
Z all other laws applicable to the construction, locatiop, and use of buildings within the City of
o Cupertino will be complied with. Yc
3 y Owner ' \ r Mt Address 6~ S cY
W a By -wjLt 5`(& Address
01
Q U Phone `� Sti Approv
State LicenseB LDING INSPECTOR
RECORD OF INSPECTION APPROVALS
FOUNDATION
DATE. INSPECTOR
UNDERFLOOR j
DATE INSPECTOR
FRAME j
DATE INSPECTOR
LATH and PLASTER
DATE INSPECTOR
FINAL BLDG. j
DATE INSPECTOR
FINAL ELEC.
DATE INSPECTOR
FINAL PLBG. j
DATE INSPECTOR
FINAL GAS
DATE INSPECTOR