1685 R ea7 t C Q LOT NO.
No.
1."Pal' vsxk 1
PS��4A-
.
i.—N BUILDING PERMIT
,ncITY UPEIILD
',:+, :.�r5. •1lIN � NUL Permit No.
-.Application is hereby made for as perI�to f2 t=C
a ® IJ t= stor�yFTyp�E�F I `((t�� c 2 E� Building
at o v 0 n'
to be occupied only as 17_ ' X 17 7 3f� �I[{j I e fz
in accordance with Plans, Specifications and Plot-Plan filed herewith.
? op
Estimated Value of Improvements,$ znnC90 Fee$ �J
it is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
a all other laws applicable to the construction, location, and use of buildings within the City of
Cupertino will be complied with.
Owner Q Y teA Al' 4,£M Address
By AddresftBU1LD41NGNSP4ECrO
CONTRACTOR, AGENT
Phon& —6 Approv
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I,. the undersigned do hereby,cert� hat
I am the owner and occu a'nt of the` Sq 1
family dweliing at ► y p r;.Rl'o2i i J cL ; Q
for which I am making applicaionao do
2 e `— C work as' a' tAh6meowner.
also c Tia7I will no.t .,hire 'any
non-licensed �q c� `ori or .contractor,
but will do this VA—rk VA—rmyself.
TELEPHOM'jM= UUNATURJS-