1640 LOT
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a) P 1 N FOR BUILDING PERMIT
APR 2 51962 CITl' OF CUPERTINO
Datenr 19S_ - Permit No.
CITY 0ppl�nEATr1N®ade for a permit to
—47
a F story,Type
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to be occupied only as 0on /\1
in accordance with Plans, Specifications and Plot-Plan filed herewith.
Estimated Value of Improvements,$_6 oQC) Fee.$__[_
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C 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
.--1 Cupertino will be complied with. p
h Owne et) Address
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CONTRACTOR, AGENT }
Phone .Q 6 6 Approv r �_
BUILDING INSPECTOR
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I, the undersigned do hereby certify that.
I am the owner asii•seei
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r which I am making applicatioir to clo
work as a AWiMeowner.
a so cer la t I will not hire any
non-licensed ley_or contractor,
but will do: work myself.
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TBI&PHONE NUMMR SIGNATURE