51181 (2)�� d��� � � �• LOT NO.
NO.?uePL
fW¢ CATtQN kkii BUILDING PERMIT
AN 24 �g TY OF�CUPF.RTINO S f a
o a � Samtary No.
ILL Date rr� [[��,� 196 Z/ Permit No.
o Application is herebYUJ1ddl�kdrla�pe r5it to f/l�
< ��
i N .a story, Type Building
to be occupied only as L'.C.�; in accordance with
0 o Plans, Specifications and Plot -Plan filed herewith. Pl Ck Fee
Estimated Value of Improvements, $ /%/�% Fee $ A, eV
o<
z J 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
d o Cupertino will be complied with.
3 < Owner Addr
—Z
a a By Address
i o Phone -��"
u Approve
State License / IL IN
es O INSPECTOR
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