51001.2 (3) I / '�"rRTM^N DV— LOT NO.
NO. STREET
APPLICATION FOR BUILDING PERMIT
x o �� CITY OF CUPERTINO
o J IAPB �9 r. II Sanitary No.
5a 9
_ Uate 196 � Permit gNo.
o
'oa �Applica[ton is�h''ereby�ln,flEoQQr;�permit to ,p
i w a story,Type Building
aW
to be occupied only as in accordance with
0 o plans, Specifications and Plot-Plan file//d//herewith. P1 Ck Fee
Estimated Value of Improvements, E h /J/JO.O o Fee$
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
J o Cupertino will be complied with. �� ,r
3 i
_ Owner Address
W Z
W e r 'BAr .
a 0Phone � Z_2 g2
qq— ',2 p:2� �_` I APProv
State License—_g2 — O MBUILNG INSPECTOR