3006 LOT NO.
NO. APPLIk IV
1 N FOR BUILDING PERM170
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i Date 196_ Permit No.
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F Application is hereby made for a permit t
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to be occupied only as
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00 in accordance with Plans, Specifications filed her ith.
F3: Estimated Value of Improvements,$ � Fez$
i J It is hereby agreed that the requirements of the Cupertino Building and Zoning O inances and
Z all other laws applicable to the construction, locatiop, and use of buildings within the City of
O Cupertino willjbcomplied with.Owned• Address%Dir/S/(���Z
t" B ��+- . Address<VI( Phon fS/O Approved
y State Licens BUILDING INSPECTO
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