1478 (2) D (O Q ^ -IJ S LOT NO.
NO. -"Si"BEET I 'zBUILDING PERMIT
® +(� C ERTINO
Date — Permit�• Permit No.
Application
/ is hereby made for
a ee mi to cnS�
a (SL LAFPCUJ E�'�`�"^ Q�^�,Jo KtY<e ix Building
at •: 1"0-v Q (�N !C L22SS
to be occupied only as
in accordance with Plans, Specifications and Plot-Plan filed herewith. m0
06
Estimated Value of Improvements,$ 0 Fee$
a,
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
Cupertino will be complied wi
h OwnerX Addreg4Z& 34W�7L.t�0�
t
BY--)(—C a Address
CONTRACTOR, AGE
{IT.1�'r9Phone — Approved
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� , BUILDING INSPEC
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I, the undersigned do hereby certify that I am
the owner and ccupant of the single family duelling at
--II G ,
0 �� S`y tt n i t which I am making
i
- - .A.1.4.-A
application to d.o � � �ro1 < a hcm . cwner,
�
I also certify* t'rt,it o;ill r^t
eN`: r contractc:;