51145 (4)LOT NO.
m NO. <TREE` .
W ¢ RRP.F CATION FOR BUILDING PERMIT
r O® C OF CUPERTINO 5165 3
0'
LL IDEC 2 765 sanitary !ice
s�
W LL Uate FG' 0M 1965 Permit No.
=0
o a CyS�pTp�icat@t�rris1�iiv®Permit to
i u a story, Type S `z'T �`e� R�%1) Building
to be occupied only as !:-S/�Ll�/` /asii�s� /,�riEt��/✓� in accordance with
00 Plans, Specifications and Plot -Plan filed herewith. PI Ck Fee
Estimated Value of Improvements, $�/w Fee $ 7�
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
0 Cupertino will be complied with. �/
3 < /Q,P� �L////G // / Address �� 6
_ m Owner
i By /= r-u-.-+--�� Address - Kg-,
o0
� U Phonr �53—OF',lX� ApP�oved
State License /9'�� emaaiNG INSPECTOa
V