51064 (3) LOT NO.
NO. STREET
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z z N FOR BUILDING PERMIT
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; � - rtteYyttJ'tt1 Ol:• CUPFRTINO
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O J C Sanitari No.
w LL Uate /SEP 16 196J . 1-6_ Permit No. �7
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0 licp��en ip�gq Rt es( a permit to �.�.r�/�[
° a Cjty Vf l�Ul(IIIV
i N a story, ype '14cle Building
ato be occupied only as in accordance with
00 plans, Specifications and Plot-Plan filed herewith� PI Ck Fee
Estimated Value of Improvements, $.$W Fee$ 10"W
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Z J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
J Z all other laws applicable to the construction, location, and use of buildings within the City of
d 0 Cupertino w"ll be�co�`'plied wi__th//
3 a tY�NCAf 3. Tt AddressZ ( /(, l C r'4'eC-k @Z'
_ N Owner
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Ce I By C� /G?� eb cS Address�`�rlb� c PRr.LS de, S.Fst 10
<u Phone Approve
` { _State Licens Bunown INS. E