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APPLIC TION, FOR 'BUILDING PERMIT
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,OF CUPERTINO
Date 195_ Permit No. D
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Application is herebyTadeif%a rmit-
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a_ �story,Type Building
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to be occupied only as /
min accordance with Plans, epecifications and Plot-Plan led herewith. b a
Estimated Value of Improvements, $ Fee$ T7 ___
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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.be complied with.
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e Owner ./�'y Address I
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CONTRACTOR, AGENT `�
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BUILDING INSPECTOR
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CERTIFICATE OF MPLETIO.,N
BUILDING INSPECT OFFI
CITY OF CUPERTINO '
Date ....1.,t 1!�.._..._........._...., 19ZO-0... Buildin Permit No.vJ� ..v......
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The Building�Lo�catat ../f�.�1(.... .. .. �/J .�... _........_.........
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Owned by ....
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(Completed) 6� _�
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Has Been (c ) For Use As: ......:r. ..
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102 7/59-500 U,//� � BIJILDINC, INSPECTOR
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