1858 %d3RZST
� �NO '„I
ION FOR BUILDING PERMIT
CITY OF CUP$RTINODateisles t Permit No. !it S�
Application is hereby made ermit to
a story,Type ilding
at
to be occupied only as
in accordance with Plans, Speci tions and Plot-Ped herewith.
Estimated Value of Improvements,$�, Fee$ t�
v
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
„j Cupertino will be complied with.
Owner � Address
By Address_
CONTR.ICTOR, AGENT
Phone Z 6 7 Z Approve
BUILDING INSPECTOR
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