4247T NO.
NO. , TRF.ET
ION FOR BUILDINI PERMIT
�`� CITY OF CUPERTI
;c ,
Date 195_ -Permit No._ y
Application is'hereby made for ptermit tq
a story, TypeBuilding
at �if rA, f , //
to be occupied only as, r��
r in accordance with Plan , Specifications and Plot -Plan filed herewith.
Estimated Value of Improvements, $ AV Fee $
u 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
"'I Cupertino will be complied wit
l Owner�r�� 6.n`• Address—�u�'/
Addres97 fi
CONTRACTOR, AGENT .�
—a ^O 9��5 Approve
BUILDING INSPECTOR
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CERTIFICATE OF�,CO 5w
BUILDING I 4u -
BUILDING INSPECTOIVS�O
'k4 CITY OF CUPFRTINOj*6,t
Date .... /// --- ----- Buil ing Permit Nq.,
The Building Located at --- ...........
::4
Owned by ... ....... . ......................... ........................................
(Completed)
Has Been For Use As: ........... ...... ...... '.-
(.Alter&d) ............... �Z� ........................
....................... - .....................................................................................................