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NO. STREET
w Z APPLICATION FOR BUILDING PERMIT
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r O t I{' CITY OF CUPERTINO
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�� Saniran, No.
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t 196_ Permit No. /
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o Application is hereby made for�permit
z in CITE a __Building
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to be occupied only a l cfUance with
0 o Plans, Specifications and lot-Plan filed herewith. Pi Ck Fee
"; Estimated Value of Improvements, $ C Fee$ Z
iJ It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
J , all other laws applicable to the construction location, and use of buildings within the City of
d o Cuper in0 will§e cooned with. �� 1
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a By Address
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State License BUILDING INSPECTOR
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