472 NO. STREET
W ¢ �P (CATION FOR BUILDING PERMIT
o CITY OF CUPERTINO
o < AP 2 1 8 Sanitary No.
SO _ pp
i Date ' 196 d ermit No. T 7�
At 1, !1 � �
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LL Application'is hereby made for a permit to
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i N a story,Type Building
a w
r to be occupied only as in accordance with
go Plans, Specifications and Plot-Plan filed herewith. P1 Ck Fee
a
Estimated Value of Improvements, $ / d Fee$
oa
z J 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 with.
Owner. ✓��yv�A �z "K Adoress�f
W a By 6Y Acldress GCllr
< 0Phone Approved dr�eirc�
_t State License BUILDING INSPECT
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