177 / /✓,9 / v�� LOT NO.
NO. STREET
I � �P 1 IC ON FOR BUILDING PERMIT
�
o ® ITY OF CUPERTINO
< (J L 11964 Sanitary No.
i U LL llate17 196 Permit No.
o CI1 YPOPi,6 7("L7�'1iiv nor a perm_.i�t..to
i U) a story,Type Building
< w
to be occupied only as
o `o in accordance with Plans, Specifi tions and/Plot-PlaA filed herewith.
F3 Estimated Value of Improvements,S�� Fee$—d-
0
d
iJ It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
.a Z all other caws applicable to the construction, location, and use of buildings within the City of
2 o Cupertino will be c plryn ied with.
3 i .GAL%/< _t:..c—F•.w �O,,y,
m Owner '�" �Address '/, e,
W a By • « Address O'W/moo .q;
<0 Phone PP
A rove
State License! _ BUILDING INSPECTOR
RECORD OF INSPECTION APPROVALS
FOUNDATION
DATE. INSPECTOR
UNDERFLOOR
DATE INSPECTOR
FRAME.
DATE INSPECTOR
LATH and PLASTER
DATE / INSPECTOR
FINAL BLDG. • ' I,/L
DATE INSPECTOR
FINAL ELEC.
DATE INSPECTOR
FINAL PLBG.
DATE INSPECTOR
FINAL GAS Adlbk
nnrE INSPECTOR