51028 LOT NO.
NO. STREET
w APPLICATION FOR BUILDING PERMIT
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s
`_ o CITY OF CUPERTINO
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o Samtara No.
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i tj LL Date �� 19(14 Permit No. Shu 1
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4 w Application is hereby made for a permit to
01
iin a story,Type`-3� / Building
ato be Occupied only as .G`'�/�/hw/e4, in accordance with
0 o Plans, Specifications and Plot-Plan filed herewith. P k Fee
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Estimated Value of Improvements, $ XZ Fee$
i J It is hereby agreed that the requirements of the Cupertino Building and Zonin rdinances and
Z all other laws applicable to the construction, location, and use of buildings within the City of
0 Cupertino will complied with.
3Q �_ m Ownerx /-Gr.2� Address
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W By Address
<0 Phone Approved
State License BUILDING INSPECTOR