NO PERMIT NUMBER (2)o% LAAA_ LOT NO. /012,/ Z
NO. STREET
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az CITV� ' OF CUPERTINO
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QO OFOUPa�tNO APPLICATION FOR BUILDING PERMIT�Xra`9
O J 19i L� Building Per, No. - I-/ a �I
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W U ,M)� ,'19_. q Sanitary Per. No. �y,���
li- o Application is"reby made for a permit to_eoA)STRsrGT
OH aD—kory, Type 'NH�2 P3LA^) y/L M Structure
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<0 to be occupied only Fm rd.Y 04)4ctt,Jrr in accordance with
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a F Plans, Specifications and Plot -Plan filed herewith. PI Ck Fee $
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20 Estimated Value of Improvements, $&DBO Fee
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Oa Total Fee $
z J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances
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and all other laws applicable to the construction, location, and use of buildings within
3 a the City of Cupertino will be complied with.
W W owner�//i�£GiFi,/f�nc.:C_ Adara.s�/1 '//�ETE.�,C.Jca�'✓; acbk)kh V/7/��r
Qp By �6/1 )E C-. Addreaa��! ✓Gr£�2AMY �' [j� jfEAj,on uI%)r
U Cont, or Agent,
Phone 3G 'a' 92 Approved
State License Building Inspector