51175I
NO. STNEET
�APPL`IC'ATIO.N FOR BUILDING PERMIT
CI(TY OF CUPERTINO ?
111 �' Sanitarc No.
19C./ ��
Uate ����' 196-7 Permit No.
�ll7S�
Application is her W18fr form permit to lferlte�
a story, Type .T Building
to be occupied only as Z l o?/%3 � in accordance with
Plans, Specifications and PlohPlan filed herewith. P1 Ck Fee
Estimated Value of Improvements, S?; fie/ Fee S 9.3�
It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
all other laws applicable to the construction, location, and use of buildings within he City of