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PPLICATION'' F R - UILDING PERMry'�//'7,
:"'.CIT OF CUPERTINO l (O ✓✓
ate sw 195 Permit No.
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S73
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Application is hereby made for a permit to A ccs 1
Building
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to be occupied only as f3ec P Lit
\ in accordancewith Plans, S ions and of-Plan filed herewi
Estimated Value of Improvements,$ AIV"O Fee$ "y,0-0
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� 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
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i Owner Address
By » Y Address
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Phone Flo APprov�
BUILDING INSPECTOR
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CERTIFICATE "
; IC*4, PLETION
BUILDING SPECPOW OFFICE
CITY OF CUPERT O
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Date ...... ....:........ . . 19.Y.1.... Building Pertnit No. ..�?...73.....
The Build in Located at _ :�.-..�.f... �.:.,..;_.^..iti.K.
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Owned by ........................:/--. .,...t-. . .....r...................._ .rf�...........'...................
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S �" 1-('A'Itered) For Use As: ......... .................................:
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� � BUILDING INSPECTOR
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