667 .02. I.SLoed
LOT NO.
NO. STREET
w �P�LI1 FOR BUILDING PERMIT
r ° ® OF CUPERTINO
rcLL ,
0 a - Sanitary No.
Date tUN2 1970 `yam Permit No. �.
° TGGes
°o Application Cis hereby made for to l'/"rr9�
a N a CITY itory��e;S�> ' Building
/ /
a = h�beoccupied only asl/,c/O-Prliha �J`�/Cre-ry[�x�maccordancewith
0 o Plans, Specifications and Plot-Plan filed herewith PI Ck Fee '
Estimated Value of Improvements,$ e !i S2 O Fee$
iJ It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
* Z all other laws applicable to the construct'an--locati a use of buildings within the City of
d 0 Cupertino will be ompliF with.
3 <
Owner- Add s
W Z
C 6 By G
a ° Phonr o2 d / C�
ll� ��(/ �S v Approved
l State Licens �+ 13 N° INSPECTOR