524 NO. STREET
W Z APPLICATION FOR BUILDING PERMIT
r ° t� CtITY OF CUPIRTINO
o a � � ;1 Sanitary No. OR
mU Dine rlrn n ten^ i �, 196_ Permit No. �t
.. Application is hereby c for rmit to
oa
dw
to be occupied only as
0 o plans, Specifications and Plot-Plan filed herewith. it
a Pl Ck Fee
3 Estimated Value of Improvements, S,�® •ry_ Fee$
iJ It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
J Z all other laws applicable to the construction, location, and use of buildings within the City of
J O Cupertino will be nnnplie with.
3 < Owner �7���� Address/
07
e
U Phon /a 1S �w'�(Jl 8 Approved
// State License /V ?3 / ING INSPECTOR