51187 (2)NO. STREET
6f;AP-P-LICATION FOR BUILDING PERMIT
Y° CITY OF CUPERTINO
(MAR 29 19 8 �t''`. Sanitary No. lk a�
W a Date 196e Permit No. S//
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�Applicatwn tsihereby.rhade fora permit to d
i N a story, Type c Building
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to be occupied only as v in accordance with
c
00 plans, Specifications and Plot -Plan filed herewith. d PI Ck Fee " 9r - per:
F 3 Estimated Value of Improvements, $ .-� R�[� Fee $ 6'5 OlJ
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z J 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 be mplied with.
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m Owner lSl �[—ir.t�, c�� Address2�;t
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a By Address�� tL/
� 0PhoneApprovedvn I_IAM D. BENEVICH
State License /S` ?! BUILDING INSPECTOR
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