NO PERMIT NUMBER (3) /3 /, I / ita r�
yT L/. (/� 1i�� LOT NO.�
N NO.
STWEET
< yrs�Z /
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j A_PPLICAT•,ION FOCUPF.RTINR BUILDING PERMIT���
Y °a ITY OF IO
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�pn !1 968 Sanitary No. S.f.33
SU
W a Date 196 Permit
N/o//./
° natio ?r fit !rl r(lTr�tn. _<l�ir'/
4 r Application I'?t-
Oil T-0 a per t to
of
i m a r_ - story,Type.-S Building
to be occupied only as in accordance with
0 o plans, Specifications and Plot-Plan filed herewith. P1 CIL Fee
"; Estimated Value of Improvements,S Fee
i 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 O Cupertino wi be c mplied with.
3i _
- Owner Addre a
rc a By 11 Addre�s�r� G ,s
0 ° Phone,�S'. — S 3 WILLIAM D. BENEVICH
_u "-'' Approved
State License s/1-7 / / ! BUILDING INSPECTOR /