100163 (2) I��0 7/_3 I /�q rry M/4y 6a6 �b c
LOT NO.
NO. STREET
N FOR BUILDING PERMIT
r ° ® r I CUPERTINO
I
i / Sanitary No.
, Date .B 7C 968 9 $ Permit No.
0
o F ApR�ir,.ltion is�here�yl made for a per-it to,Add
z w a ll �I �Y (slibry,� �e Building
r i to be occupied only as ►C / [ y "p. in accordance with
20 Plans, Specifications and Plot-Plan file/{ herewith. PI Ck Fee
t- ; Estimated Value of Improvements, Fee
zJ 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 be complied with.
3 m p 0 offle 7 Address, /e 7/ 3 ev ft/aa
W Z
W y Address '
< o
_U " Approve
` State License JE�:��
BUILDING INSPECTOR
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