838 (2) LOTNO.- :
NO - STREET
_ 1 rl ION FOR BUILDING PERMIT
CITY OF CUPERTINO
at 19 Permit No.
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A licati for a permit to (/JO.IrA
s ory,- ype Building
t
at
to be occupied only at
in accordance with Plans, Specifigz4fle
and Plot-Plo&d herewith.
Estimated Value of Improveine s, 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
„j Cupertino will be complied with.
Owne .e%k//_; ;;,�ol�n�z_nAddress
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By J Address
NTRACTOR, AGENT
Phone 5&• Approved
BUILDING INSPECTOR
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--. I`the undersigned do hereby' certify tk at:,I ;m .
the owner and occupant of the single f,U1111y dwlling at
7
l_for which I atr: making
application to do
> work as a home owner, .
I also certify that I cr1S, not'hire any non licensed
.,...or. Contractor, blit ... ... . . .<.._ . . . -.. .
f will do this.work nysel£.
TEIEPI'Ol'E .A;Ui BL_R:,. „ .
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