51175any
LOT NO.��
NO,
TREET
A:PP_LICATIOIK FOR BUILDING PERMIT
C'IIT'+Y� OF CUPERTINO
DEC G 1 Sanitan No. 3 23
Uate
196-,2 Permit No.
CAp'plication•is Iter y mane forapermit to 2!2_ -!
a _� story, Type � � �.,�G Building
t,, be occupied only as �.Yl/�X �� "" .2± in accordance with
Plans, Specifications and Plot -Plan filed herewith. PI Ck Fee
Estimated Value of Improvements, S3S,IMQ Fee $ 1057 a —
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 the City of
Cupertino will be complied with.
Address��s�//.3Y-
Addres 3�
Approved /
UILDING INSY F.CT00.