NO PERMIT NUMBER/ V7-0(G a rdo F_e, LOT NO.1092-1 Z
NO. STREET
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w Z CITV�' OF CUPERTINO
QO OFOUPa�tNO APPLICATION FOR BUILDING PERMIT�Xra`9
O J 19i L� Building Per, No.-I-/a �I
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W U ,M)� , '19_. q Sanitary Per. No.�y,7 ��
li-o Application is"reby made for a permit to_eoA)S7-9"eT
OH aD—kory, Type 'NH�2 P3LA^) y/L M Structure
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<0 to be occupied only FAM rd.Y 04)4ctr,Jtr in accordance with
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a F Plans, Specifications and Plot-Plan filed herewith. PI Ck Fee$
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20 Estimated Value of Improvements, $&DBO Fee$_13L
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Oa Total Fee$
z J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances
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and all other laws applicable to the construction, location, and use of buildings within
3 a the City of Cupertino will be complied with.
WQp owner � . , . ; acb )kh Address
By /�HZI�-&i )E n-. Addreaa��7 117Ce.4NS
k' b /lFl/rbon ul�r
U Contr.or Agent,
Phone �G Approved
State License Building Inspector