197 (2) 1•Qirb ,J7L�t'v CK-16 t< LOT NO.
NO. STREET
zAPPLICATION FOR BUILDING PERMIT
E a
r O CITY OF CUPERTINO
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O Sanita rV NO.
W Date , I Permit No. 197
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o Application is hereby made for a permit to NEZ�J s X s r S�G
z N a story,Type O N ST&241'V'1 Sr— S ( l7C_ • Building
aw
to be occupied only as
0 o in accordance with Plans, Specifications and Plot-Plan filed herewith. $p
> ; Estimated Value of Improvements,S��v Fee$
iJ It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
* = all other laws applicable to the construction, locatiop, and use of,buildings within the City of
J o Cupertino willb`e�complied w
m Owner
3 < S I7 � C`Jl C- �CJ Address�(OCIK%On/�'
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W a By PgjN�L �C �; GG Address
<U Phone -z6-2_ Approved
State License�u C 75 G�(i BUILDING INSPECTOR
RECORD OF INSPECTION APPROVALS
FOUNDATION I
DATE INSPECTOR
UNDERFLOOR
DATE INSPECTOR
FRAME
DATE INSPECTOR
LATH and PLASTER I
DATE. INSPECTOR
FINAL BLDG.
DATE INSPECTOR
FINAL ELEC. I
DATE INSPECTOR
FINAL PLBG.
DATE INSPECTOR
FINAL GAS
DATE INSPECTOR