51140 (3) 1�j:ZO(v� �y3z
LOT NO.
NO. STREET
N
W = APPLICATION FOR BUILDING PERMIT
sa
° ITY OF CUPF.RTINO
Q LL
5 < Sanitary No.
U
i LL Uate % ermlt No. .67 /40
0 77
'o Application is hereby19m e fo ' mit to
a In a-- nco
r Building
n.be occuply a I e in accordance with
0 o Plans, Specifications d PlobPlan filed herewrt11 Pl Ck Fee
E6.6
stimated Value of Improvements, S t�0 D 6 Fee=
iJ 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
o Cupertino be co pliedwith /
w Owne �, (/ � dress 20
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a a By Address JW,, r
02 Z 5' S 3 / rl
U Phone ^/—� Approved
State License �W c 19_c /e.< BUILDING INSPECTOR