500 t sTxaBr
APPLIC/�►TiC�N FOR �UILt?IPIG PERMtT
:' cirx a� cuPlr�rnvo
Da I95.� � Permit No ---_
n sd `permIt to-- � =—
�.
Budding
It A Story, �r�e.. — ----
�' ' At �E {�-_ - -
#a be occurredonly -S' - � •,�"r` %
in accordance with Plan<, Speaficattons and„Plot �an±�Tled he 'ti,
'Estimated:Value of lmprovements, $
v It is hereby agreed that the requlren,ents of the Cupertino BLildinR and Zonmq Ordinances and
a}1 other .Isws applicable to the constiuctron; ,oration and use "oE, buildings crlthin hhe Gty ;of
a -Cupertino wilt be cvniphed with.
v, Owner �✓rvt��a � Add ,
AddressC� zY a
By co�NrancroR, �ezrr tlpprove
Phone / - �� / --” ; BUILDING INSPECTOR