15221 (3) 1515 S9YAtogA�Sannyvale Road
APPLICATION FOR
CER IFICAM OF OCCUPANCY
Use classificaticn-5u,�� g- Permit No.
Croup a Type of construction \J N Use Zone C�
owner o�Cctld-fo
Address
Building Address
j`j 15 en
Portion of building
FPB f4vroval necessary By: {� �N
E,73 `s vNo Date:
Disposition of certificate:
Date routed to FPB
Date mailed to owner
Form 280-668