51145 (4) LOT NO. '1 !I
H NO, � TISEE_ra
W z APPLICATION FOR BUILDING PERM�T
r O CITY OF CUPERTINO
o < (DEC 21. 1965 Sanita No. ��'�
5U
Uate1 F_C bI9(y� Permit No.
.. w C'ATpVlicnon is h r y IgAll r a permit to jYE.QCL7_
o1 1
i in a story,Type ,Ci—IS (�D 3y/ �6flsy/ Building
ito be occupied only as9--<2'iY,</ in accordance with
20 Plans, Specifications and Plot-Plan filed herewith. PI Ck Fee
Estimated Value of Improvements, $ -2 51/ 400 Fee
iJ 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
O Cupertino will be compli d with.
3 N 0wnerlel"l-_2 ® v Address
WBJ y { � ]W�
R 4 /'T�i ' Ie$$' ,
0Phone�Z.T,�--f,Y '.X� Approve -
State License /q—=609 a IE ING INSPECTOR