196 (2) %o S
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LOT NO.
NO. STREET
w Z APPLICATION FOR BUILDING PERMIT
0 CITY OF CUPERTINO
Y LL
0
o Sanitart• No.
SV AtiG�• �/ ..
i n Date L/ 196 Permit NO.�Z
`o < Application is hereby made for a permit to r -/2e5e-% 4/60d SlMI S�- J
iU1 a story,Type C�/may sHL—�_ r� Building
< w
? to be occupied only as
00 in accordance with Plans, Specifications and Plot-Plan filed herewith. �O
> N ei•7J
r 0 Estimated Value of Improvements,S -- Fee S
0 c
Z J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
* Z all other laws applicable to the construction, location, and use of buildings within the City of
J 0 Cupertino will be complied with. (' '� JJ
A
3 Q Owner SH L O/C �n Address_S�/k-!o nI Y7-s-- rllc
N_
w GLGF Address
By tl iV G6 nN 233 jU lblon/t/oohx �s/"
OZ
-U Phone
/ Approved
State License fL `� ��// I BUILDING INSPECTOR
RECORD OF INSPECTION APPROVALS
FOUNDATION
DATE INSPECTOR
UNDERFLOOR
DATE INSPECTOR
FRAME
DATE INSPECTOR
LATH and PLASTER
DATE. INSPECTOR
FINAL BLDG.
DATE INSPECTOR
FINAL ELEC. .
DATE. INSPECTOR
FINAL PLBG.
DATE INSPECTOR
FINAL GAS
DATE INSPECTOR