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I OT NO.
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�A N FOR BUILDING PERMIT
oOF CUPFRTINO
o PR 1g Samtara No.
Date 196_ Permit No.
0 . CITYppl�tlri tWPERr�i'M Or a permit to /I�'
a 1 1\l�
i m a story,Type Building
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to be occupied only as S%,t/G l E F//" t in accordance with
0 o Plans, Specifications and Plot-Plan filed herewitp Pl Ck Fee
Estimated Value of Improvements, $ SOOG Fee$
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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
d O Cupertino will be com lied with.
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_ N Owner / Address/0
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a By o Address t 6 _
<0 State
L ' ��/�'y���/3 [�).� Approved
State License qqV /r/ B LDING INSVF.CI'OR
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