366 LOT NO.
STREET
APPLICATION FOR BUILDING PERMIT
�".� {�I OF CUPERTINO
Date `ate•J�YI n
Ap a�MfteaUrt9%or itta _story,TypeBuilding
at CITY OF C
t� to be occupied only as
in accordance with Plans, Spe cations and Plot-Plan led herewith. '/
u Estimated Value of Improv ents,$ �, Fee$ 44.
u It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
all other laws applidble to the construction, location, and use of buildings within the City of
Cupertino will be complied with.
vt O*iiir //l,,,CC77may Address a0 Ly
p r .1L� _�!(/ Address `SH/�/1%0 6}
r CONTRACTOR, AGENT
Phone L''2- -31 Approved
. BUILDING INSPECTOR
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