825 (2) C-3 LOTNO.
NO. STREET
APPLICATION FOR BUILDING PERMIT
CITY
;OF CUPERTINO �•
rfa 195_ ermit No.
Applic')n f elheQby'mFJfor a per it to
7" ® CUFr�y,Type ttYll Building
CITY
to be occupied only
in accordance with Plans, Specificatio and Plot-Plan filed herewith. Q
00
Estimated Value of Improvements,$ Fee$_
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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
Cupertino wi/l II be/m
copli d with.
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Owner.z n� ( ' Address
By Address
CONTRACTOR ADE T
Phone ,• s� APProved IP,.,the-�
BUILDING INSPECTOR
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