51075.11 (2) j.q7q
No. - i' Street Lot No.
CTW CITY OF CUPERTINO
DEC 1 197APPLICATION FOR BUILDING PERMIT
DateSanitary No.
19
m p — Permit No.
Y .E Apphc fion is hereby made for a permit to
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3 � a�� story,Type.S=NrS� �( 00 Building
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to be occupied only as in accordance with
° Plans,Specifications and Plot-Plan filed herewith. PI Ck Fee
Estimated Value of Improvements,$/Sf 0 00 Fee
—'p It is hereby agreed that the requirements of the Cupertino Building and Zoning Ora`inances and
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> all other laws applicable to the construction, location, and use of buildings within the City of
A Cupertino will be complied
plied with..
° Owner
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ro BY
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E Phone �' 7 — a-u / 0 Approved
/ State License `%9 a S Z g Inspector
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