101 /0 a �f.L-- � :fid• T NO,
NO. STREET
z XA'PPLICAT N FOR BUILDING PERMIT
° EEC
�rY OF CUPERTINO
o a �y� Sanitary No.
W C D 11e 5 19&3 ""�" 196_ Permit No. /n
1 LL /
F °
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CIA lication i hereby.made.for a permit to
CiCi l ur«=rs, t1
z N a stor , ' Buil IT
aw �
ato be occupied only as
0 o in accordance with Plans, Specifications a Plot-PTI- filed herewith. (o-O
Estimated Value of Improvements,$,/OOO Fee$
oa
z J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
* i all other laws applicable to the construction, location, and use of buildings within the City of
d o Cupertino wIl be complied with.
Owne
3 ��r -s>?l:o Addre,IOA6o Saco-T•a..._—s.;y-Ae-
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Q a oe4 r Address/ Z�
S S 4i
a U Phone - - Approved
State Licens /-15 T-iT- BUILDING INSPECTOR
RECORD F NSPE PPROVALS
FOUNDATION I 1
DA P. J INSPECTOR
UNDERFLOOR
DATE INSPECTOR
FRAME
DATE INSPECTOR
LATH and PLASTER I
2 DAT INSPECTOR
FINAL BLDG. + K , Y i
DATE INSPECTOR
FINAL ELEC.
DATE INSPECTOR
FINAL PLBG. _
DATE INSPECTOR
FINAL GAS
DATE INSPECTOR
M