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APPL CI ATION'R BUILDING PERMIT
rIDEC 7 1965 CITY OP CUPERTINO
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o a Sanitary No. p /
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r `o U h�ifT z-ff t In[OT1' IA 196_ rmit No.
o Application is hereby made f a permit to
i to a st Typ / Building
<w
= to be occupied onlyas dance with
0 o Plans, Specifications and Plot n filed herewith. PI Ck Fee
> 0
F ; Estimated Value of improvements, 3 2' Fee E
iJ 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.
3 m OwnerJ�A S s lD/FF aaz> r Address Y /00 7/ &A E�/�AV,
W a By AD 19k i CZ/15-41 Cn. Address / 2- —Th+ y J
<o Phone 3l L%2 ^37j'7 z
State License / 223 8'y C,^ fiUILDTNG INSPECTOR
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