51114'7,71
APPIIISATION FOR BUILDING PERMIT
® OF CUPERTINO
Sanitary No.
Dat 1 IC16F;_ 96_ rmit No.
Application is hereby made for a pe it o
a to�t1lJyby�Building
to be occupied only as _ cordance with
Plans, Specifications and Plot-Planfiled wrt 11 Ck Fee
Estimated Value of Improvements, S _ �. Fee $�
It is hereby agreed that the requireme s of the Cupertino Building and Zoning Ordinances and
all other laws applicable to the construction, location, and use of buildings within the City of
Cupertinowil e complied/3/with.
Owner= !
By
a 0 Phone 3-10 .37
State License
Address
Address
Approved
IIDING INSPECTOR ,/�