2155 V� I V [C' RS L ]fi20 LOT NO.
NO. STREET
® PSL Ce�T�O OR BUILDING PERMIT
r g I (JP CUPERTINO
OJ
3 < , FEB Sanitary No.
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u 1 X863 1 _ Permit No.
w 0 Date
Zo
2—
.. r A@KIiS'o mit to �
�'er�'y
'z m aLc3KIlt story,Type e)i2ty J Q/ne—1 Building
to be occupied only as 6� O° X
00 in accordance with Plans, Specifications and Plot-PI filed herewith. oe
� 3 Estimated Value of Improvements,$ �00. Fee$ 3
i J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
J Z all other laws applicable to the con (ruction, location, and use of buildings within the City of
J®rate
pertmo complied s 'h QQ
wner G� � AddressAddress
onA7/ o?-(90/ Approve Licens .UE BmcotNc INSPECTOR
RECORD OF INSPECTION APPROVALS
FOUNDATION
DATE INSPEC"f0R
UNDERFLOOR
DATE INSPECTOR
FRAME
D TE: INSPECTOR
LATH and PLASTER
l ATE INSPECTOR
FINAL BLDG. + I q acommu4
DATE INSPECTOR'"
FINAL ELEC.
DATE INSPECTOR
FINAL PLBG.
DATE INSPECTOR
FINAL GAS
DATE, INSPECTOR