1140 LOT NO._, 1
NO.•. STR! n '-.`
<► _ IONI ',FOR'BUILDING PERMIT(/�F: .'
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"t ;OF-CUPFRTIN
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K, � • ��= t93�� Permit No. I 14
Application 1 isppheereepb.Jyy made fo%�+-a-'peimit to
$�F—G-11 b'Y; lYl��oo7r:':".`�',% J L/Q�✓ Btiildili9
' at '0-00"-"�� e
LJ to be occupied only as �c inFi✓GF
in accordance with Plans, Specifications and Plot-Plan filed herewith. "
Estimated Value of Improvements, Q-0�0 Fee$
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- ❑ It is hereby agreed that the requirements of the Cupertino Building andZoning Ordinances and
all':otber laws applicable to the; construction, location, and use of buildings within the City of
a Cjxrtmo will be complied with. ,
• :d ' Ownex '/,';/A
i By ~)iddress
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C N IiACTOR, AGENT �
'I Phone pproved. .� ..
,• .i P', ._1 6UILDINGF[`9 rCTOR tS
RECORD OF INSPECTION APPROVALS
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