478 NO. STREET
W APPLICATION FOR BUILDING PERMIT
EX
° C W W, CITY OF CUPERTINO
Q LL
0 Sanitary No.
5
1968
i `o Date
—APR2 196_ Permit No. 7 8! _
o < Applicatipnks t�eroy made for a.permit to �—
i m a tt'' story,Typeqq S— /c�") ,J'— Building
to be occupied only as �(l a_�_��� �—�� iU ❑ accordance with
00 Plans, Specifications and Plot-Plan filed herewith. PI Ck Fee
Estimated Value of Improvements, $ Fee S-7 0_
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 omp11 d with.
— 0
m Owner — �`R �• Address
WZ
W a By Q + �� Address
io
_C Phone Approved
/- State License BUILDING INSPECTOR