51140 w � 47() µii
LOT NO.
® N ET
w APP�LCICMITY
N FOR BUILDING PERMIT
g (JUL �. 1965 OF CUPERTINO
o Samtary No.
5 �
rtflifj' / 196 -5 mit No.
o N�,
`o < Application is hereby made for a mit to r '
i m a story,TIrnr Building
< w
be occupied onl
0 o Plans, Specifications and Plot-Pla led herewith PI C ee ��
m6
F ; Estimated Value of Improvements, Fee$
i 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
O Cupertino will a mplied with
3Q
_ < Owner 2 � Address
W n By e Address /I?D JDs j
J
PhoneApproved
State License
.Jf.[/ BUIL GINS PF.CTOR