51167.1 (�ti5 ///o SJ44md AMC-
NO. $TREE
Na APPLICATION FOR BUILDING PERMIT
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Y o CITY OF CUPERTINO
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oa Sanitary No. 56
5 �5i/67 /
i 4 Ua 196 Permit No.
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`o � pl>�i aiort'i�h�t�Wma rapermitto ECT
i m a (� 7ZY (� s or TFX e -�J _Building
tt�'ff�bctupi2' only" in ar� ce with
0 o Plans, Specifications and Plot-Plan filed herewith. PI Ck Fee
> ; Estimated Value of Improvements, $ VA 0 O Fee$ 1100
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z It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
j all other laws applicable to the construction, location, and use of buildings within the City of
Cuperti )will be complied�'Sith.
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ownerTZ C/Lt--�.vi Address a29-S /
By L� Address /
-u Phon Z ��
Approve
State Lice ns � — ootn G "sV'c OR