258 (2) LOT NO.
NO. STREET _
21 5 5 APP=ATIPN FOR BUILDING PERMIT
:TY OF CUPERTINO
1 Date �/ `�,� 19$, Permit NO.-
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Applicat s'heret y mad or a permit
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a u i'to
y� — Building
to be occv , oras
in accordance with Plans, Specifica ons an Plot-P n filed herewith.
Estimated Value of Improvements,$ Fee$
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It is-hereby agreed that the requirements of the Cupertino Building and Zoning rdinances and
a all other ppli le to th construction„location, and use o� uildings within the City of,
Cupertino rl lied wit i VAC/CCS
v� Owner Address _
By ? - Ask, Address / /
Phone r; Approved—
c�NT Approved (i��J -c,c.-� •,[tom, .
�! 'f1� -- BUILDING INSPECTOR
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CERTIFICATE OF COMPLETION '
BUILDING INSPECTOR'S OFFICE
f CITY OF CUPERTINO
Date .... G!�L....---...-................ 1953.._ Building Permit No. - ...f....----
The Buildin Located:at /_ /t!
Owned by'
(Completed) J
Has Been . - For Use As: ....-e !. -/
.............................. ........._.................. - - ...
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103 2/59-250
BUII-'DING INSPBCI'OR
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