1217 (2) LOT NO.
,f NO. STREET
It A�P,,LI 'ATION FOR BUIL6"IWCy PERMIT
* CI-W OF CUPERTINO
Date 195_ Permit No. Z 7
Application is hereby made f a permit to
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a V 0�. story,TYPe�C5nn'd"D Ir. (.J
at I t�' 'l 1z' tycc� C� 1�b3 l
to be occupied only as hFa 1 t' W
in.accordance with Plans, Specifications and 26-Plan filed herewith.
DU oQ
Estimated Value of Improvements,$ DID '— Fee$
v
It is hereby greed that the requir lents of the Cupertino Building and Zoning Ordinances and
u all other laws applicable [o the n ruction, location, and use of buildings within the City of
;,a Cupertino will be complied with. -
^ Owner Address
h
By Address
Y �.?' �i
� RAC (T
'�Phone Approve
BUILDING INSPECTOR
RECORD OF INSPECTION tA ROVALS V 1 r
FOUNDATION
DATE INSPECTOR
FRAME
DATE .INP I
<1!1
LATH and PLASTER I
DA INSPECT*..'
FINAL BLDG. I
DA INSPECTOR
-
FINAL ELEC.
DATE INSPECTOR
FINAL PLBG.
DATE INSPECTOR
FINAL GAS
DATE INSPECTOR
I, the un ersig.7ed do
hereby e- that I am
4
the ovmer and upant of thdowelling at-,
I CI am making
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application to do � ��yy r'lv is a home ova�er.
also certif-
y tiiCt ? Will ?'ip I".joie any riOTI-liCe::sed
PL`s"�tf contractor, but will do this -cork myself.
62
`X ,1,42-galf O_
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