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P LII FOR BUILDING PERMIT
® OF CUPF.RTINO
Sanitary No._
Date 8 6 � Permit No. .5-1/ `lz4—
Application is hereby made fqL j permit to &I -ea T Co ✓erg
Building
to be occupied only as o Tic, d o el e1q in accordance with
Plans, Specifications and Plot -Plan filed herewith. P1 Ck Fee
Estimated Value of Improvements, E rn/» Cti Fee $
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
Cupertino wilQr complied with.
Owners Ap ??//W� /.5 5 &/ Addrress��Ce-3 Z / yd Cj.
$y-�i',y r7"3,H�u Niut�,v/ Qcds.—:d'ess
Phone'7�i
Approved v \
State License Z ��G BU n: ING WSPECI'OR /