51145 (3) �1 CFtc/
5 y 11S63 'e�y '4.syA- [ �i.�r LOT NO.
NO. STREET
Wz APPLICATION FOR BUILDING PERMIT
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o CITY OF CUPERTINO
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o Sanitary No. 9
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iLL I : 196 Permit No.
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o F MARtion a heeree y ma a or a permit to
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i in a Building
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I tEt•B o cupled only asF«�^!'S in accordance with
20 Plans, Specifications and Plot-Plan filed herewith. Pl Ck Fee
Estimated Value of Improvements, $ � Fez$ %S 'x
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
J o Cupertino will be < mplied with.
Ow �"� d!<sica�ilt� P Address
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W a By Address ��BoX ejy
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<u Phone Z�3 Approved WILLIAM D. 6ENEVICH
State License 160/ BUILDING INSPECTOR
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