51145 (3) AAvl�- t OT 1404�
Pa�srR,E'r'
w p FaAVP
AT101N FOR BUILDING PERMIT
go ITK; OF CUPERTINO
; EC 21 1965 tom+ Sanirary \o.
5 �
U
W a Uate 96,L Permit No.
' o 1, I�
o Application is- Lby mad' tbr a permit to
i In a story,Type .T rT 403 ,4--'WV Building
to be occupied only as'/1- '4Az,',zVW in accordance with
0 o Plans, Specifications and Plot-Plan filed herewith. PI Ck Fee
> 0 Estimated Value of Improvements, $ -Z(, 0-0 Fee$ /.l.J>
i J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
* = all other laws applicable to the construction, location, and use of buildings within the City of
d o Cupertino will be complied with.
NOwner Address,0
W e Byv. /U Address
`U Phone pproved
State License BUitgNG INSPECTOR