100046 ya7
LOT NO.
NO. STREET
W APPLICATION FOR BUILDING PERMIT
r o CITY OF CUPERTINO
K h
0 ' Sanitary No./
50 N
ILL Date _ 19f>,f— F mit o "ed U
ro
01 Application is hereby made for a permit
o '
i N a_1 story,Type O 02
Building
< w
ai be occupied onl0 n accordance with
00 Plans, Specifications and Plot-Plan filed[he,r�e,wlt�� PI Ck Fee
> ; Estimated Value of Improvements, St. 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
d o Cupertino will be complied w'th.
3i
Owner Address
w z
a By Address
a J PI1O"e Approved -
"" ----State License - -- BUILDING..INSPECTOR_ - __--
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