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w APPLICATION FOR BUILDING PERMIT
rg CITY OF CUPERTINO
o a Sanitary No.
50 � y
Date � 196 Permit No. / 0�
o
o Application is hereby made for a permit tom— E�K
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z a a story,Type ��S �X Building
to be occupied only as � in accordance with
00 Plans, Specifications and Plot-Plan filed herewith. PI CIL Fe
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Estimated Value of Improvements, $ Fee 3
iJ It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
J i all other laws applicable to the const uction, location, and use of buildings within the City of
d O Cupertino wiy b/ee complied with.
N OwnerT W416'07�� Address
I, a Bya ���Q Address 7
< 0 Phonea 93 Approve Xit Q G
State Li Ce Vz'z't7�11BUILDING INSPECTOR