NO PERMIT NUMBER (3) �OM/ NK SARI+-ToGK -Sid uc;'•IIALI� 7� D. LOT NO.
NO. STREET
CITY OF CUPERTINO f� •�
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Yo m o% 13APPLICATION FOR BUILDING PERMIT
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O-t V` Building Per.No.
Wo Date 6 , 7g� Sanitary Per.No.
�o ApjIPcatrion is hereby made for a permit to cu - e C Lr .
oa_storY, TEXISTICrSIt>L1 ►
>F Type Structure
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H to be occupied only as C aeo in accordance with
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a F Plans, Specifications and Plot-Plan filed herewith. PI Ck Fee$
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2o Estimated Value of Improvements,$ 6" °4 Fee$
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o a Total Fee$ L'L
z J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances
Z and all other laws applicable to the construction, location, and use of buildings within
3 a the City of Cupertino will be complied with.
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ww owner -rDnDk/P;N$ Address SAPN i0('A-S01UrLyy/I
ao By /=EDC,2vL Z516-vsAddress �S Ji 7'4kl /.t//j'G�!/C= /'�D'
U Contr.or Agent. saw
Phone 2912 -r)9';-_(o APprovetl _ LA
State License .7/ 7 7 °3 D 4 Building Inspector