51038 v�/Q✓y- .0or"irAtl GM/G 9R IAT NO.
NO. STREET
wp ISA N FOR BUILDING PERMIT
tX -
OF t"FRTINO
5 < SEP 17 1965 sanitary No.
u LL Uare 196_ Permit No.
0
UJ I' on permit to
cir�p �a P c 6
i N a story,Type � /O �� ~ Building
o be occupied only as (GR�.y �AT�C 1 n accordance with
00 Plans, Specifications and Plot-Plan filed herewith. PI Ck Fee
> N p 0 _ /.
F 3: Estimated Value of Improvements, $ - Fee$ I
oa
z J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
J z all other laws 4pplicable to the construction, location, and use of buildings within the City of
o Cupertino compliedwith. w -
3Q N
_ Ownyer �� � ess
W a By 1"10 IN M/• Address
< 0 Phone 97 XZ V���'� Approve 1T1
State License BUILDING INSFF
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