282 (2) OT NO.
NO. STREET - "
2 1 55 APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Date �� (� - 195 Permit No../ � ______
Appli I`tion'i'sJJhere§ maale fo�,r aa,pe� to —I fZl �1
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Buildin
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to be occupie�iYAstlt (, t�f.l :1`,tl o
n accordance-with Y�Plans, Specificati s a d Plot-Pla filed herewith.
Estimated Value of Improvements,$� Fee$ACL_
it is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
a all other laws applicab a to the construction, location, and use of buildings within the City of
Cupertino w' a co led with.
in Owner Address
By -/ Address A
Phone Ar �J h.- Approved ga rl.�.�..t L�
BOILDING'INSPECTOR `��
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CERTIFICATE OF COMPLETION :
BUILDING INSPECTOR'S OFFICE
CITY OP CUPERTINO
Dnte -...,c: ./✓1..:-...._...... 195y-'..... Building Permit No.;.,,',' ; .......
'The Building Located at �, �%f( !' t• `. .r.+-.t rf�,�-
Owned by .(.' ' f. • .'... : '..`�/ •d ! J-r!;2?'V.::! .%.✓.!i , ..............
Has Been
(Completed) r`/� + ..'
For Use As --.
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Altered
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- „✓" BUILDIN(: 1NSPECt'OR
tn2 2/59-250 -
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