51037 9 7a NO.
NO. STREET
z APPLICATION FOR BUILDING PERMIT
° 1, f DEC 21 � 7 C OF CUPERTINO
9 a ! Sanitary No.
5U
_ , Date 196_ rmit No. -.5-108 -7
0 liQr-PTIKIn
o W Application is hereb de Eor a-perrm
aa story,Ty ng
W
r to be occupied onl with
00 Plans, Specifications and Plot-Plan filed rewrtty PI It Fee
Estimated Value of Improvements,S �5�, ~y Fee$
iJ 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
3 < Cupertin�will be complied w't/
Owner /tJG/.�..�/��l/Yp i/ Address
rc a By x &,izx Address
< o Phone� •7 -�r 49 9
_U Approve
IState License INO INSPECTOR /