441/D / Q / ��%i �C/G� ��� LOT NO
NO. STREET
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W Z L T N FOR BUILDING PERMIT
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° I OF CUPERTINO
o a Sanitary No.
s yi= LL Date' i t �+�67 36 Permit No._
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0 W Application is hereb made fora permit to --
i V)a stot�!pI ` F iiX _G Euilding
a W In
to be occupied only as b IL?) � VL in accordance with
a
0 o Plans, Specifications and Plot -Plan filed herewith. PI Ck Fee
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3 Estimated Value of Improvements, $ 2 O C7 Fee $
i J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
* Z all other laws applicable to the construction, location, and use of buildings within the City of
o Cupertino will be complied with.
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- a Owner ( Address
W a $y �`�s �J i^�Vl� Addre `Z (fEbcJrtlyd t/ �9t-+�
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Phone o� q C c..�
State License L (!j Q / ` L/ \ pp .DING INst'EC1OR