445 16045-/ I �. EST�i s ys�
LOT NO.
H < NO. ^ �1 E��\
�APPLICATIQNtX FOR BUILDING PERMIT
rc ° Ce1TYl OF CUPERTINO
° 'OV� 8 1 Sanitary No.
i 4 Dater– _ 196-7Permit No.
° l Ttr nr iE�EG7- i¢
SSG ir/
oQ CApplHll icationishefe¢y0`"Ifo//ibpermitto
in a story,Type b�X �J Building
W
to be occupied only as � in accordance with
0 o Plans, Specifications and Plot-Plan filed herewith. PI Ck Fee
?: Estimated Value of Improvements, E Zia �— Fee$ �� d
iJ 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
O Cupertino will be com lied with.
- Owner Address /t
Q n By /3.Pi TE L iTc�- Address 20 9��qui
i o Phone �L9' '7 0 3 7 PP
-0 State License
15 -5-771 �A fOVC BUILDING INSPECTOR