51003 (2) 1 �(/*�]�
GJ°`i ' Ga,l LAN t> rve LOT NO.
® TRT
w zz AFF Z T FOR BUILDING_ PERMIT
o ° 7 1966 OF CUPF.RTINO
Sanitary No.
5 � -
i `o
Da 196_ Permit No.
'57100 :3
App ,ca
Ion is ere y ma a ore permit to EQEcqv—
'z Ul a--M—h.)-r— story,Type
,w. to be occupied only as —� i� dance with
20 Plans, Specifications and Plot- Ian filed herewith. Pl Ck Fee
F "; Estimated Value of Improvements, $ �DD�
i J It is hereby agreed that the requirements of the Cupertino Buildi 'nances and
J = all other laws applicable to the construction, location, and use o buildin t e City of
0 Cupertino wIII be complied with.
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a a OwnerAddress A�Od
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Approved
State Licens,'X7-4A ; i[l� BUILDING INSPECTOR