51181 (3)31° 1, ��s% 6, Qz LOT NO. ¢� i
STREET
w a /+ APPLICATION FOR BUILDING PERMIT
s o MAR y 196$ 'UCITY OF CUPERTINO V� �/
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o a �,/ ��/� Sanitary No. 6
w Date, r 196 Permit No.
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o Application is hereby made for a permit to
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story, Type i��cBuilding
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to be occupied only as F.Q in accordance with
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_o o Plans, Specifications and Plot -Plan filed herewith. Pl Ck Fee
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g Estimated Value of Improvements, $ Fee $ d0 0(�
z J 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
J o Cupertino will be complied with.
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Owner Address
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i By /-/�/�2 Address 2295 BE t • CRI 17 of vn
0 Phone >��y (�/��� Approve�ANTA CLARA, CALIF. 95050
r\ State License ��j WILUUIDING!NSPECTOKI:ZVIC J