3954 LOT NO."
/ 3 _
w Q AP FOR BUILDING PERMIT
° MAR 6 19G4 �
r OF CUPERTINO ''jj
CLL Sanitary No.v'�
O J
a „ Dom+—••—.�� `�:•••—•-- •- 196Y Permit No. Q
= o /��y
o W L Application is hereby made for a permit to &C, • _
a �U) a _story,Type / Building
w
to be occupied only as
a
00 in accordance with Plans, Specifications and Plot-Plan filed herewith
0 ; Estimated Value of Improvements,$ .2600 7 Fce � �0/
iJ It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
J Z all other laws applicable to the construction, locatiop, and use of buildings within the City of
J o Cupertino will be compiled with.
3Q
_ m Owner Address
W Z ^
a a By �+-� Address
a 0 Phone —S0 `3 - Approv d
�j� State License �� B O INSPECTOR
Qm F
v u u u u u
y w m w w w w
Q;
ac
0 �
.F
� 1
F
OC
O x
W
W' R
O • e
W