569 LOT NO.
NO. STREET ,.
IppPy`��1i�O,s1 FOR BUILDING PERMIT
I�'aa1 � CUPERTINO �yDate OV 19 4nr^ tr Permit No. J /
474.7 � i
Apica_tion is
hereby made for a permit to
a ( T/ Ar,fid? 4— Building
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at .
to be occupied only asnf12.rF
in accordance with Plans, Specifications and Plot;Plan filed herewith.
Estimated Value of Improvements, c —V Fee
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c It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
all other laws applicable to the construction, location, and use of buildings within the City of
Cupertino will�b�e complied with.
Owner 4 . r Address/9__.;5�
By Address Z` `
CONTRACTOR, A ENT
Phone — � 6 Approved
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