252 (2) Lor NO.
NO. STREET
2 15 5 APPLICATION FOR BUILDING„ PERMIT
CITY OF CUPERTINO
Date --_ �5� Permit No. /
Atd /LQ�e
Applicatl n Is hereby made fora Ni to
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a story,Ty _ Building
at — _
to be ocn pie onI U
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in accordance with Plans, Specificati s• d Plot-PI, filed herewith.
9 17
u Estimated Value of Improvements,$ J Fee$
i 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
'—1 Cupertino Com 'fd with.
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Owner Address
By Address
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Phone %�/ iC._ o.L —/3�' Approved `'G .c=� --uc
c BUILDING INSPECTOR�`—
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