100139 (7) I%/cS'o i �
� �4RY Aven LOT N°. 3�
NO. STREET
W C- C. %PbLICATION FOR BUILDING PERMIT
Ep
° CITY OF CUPF.RTINO
APR2 41968 Sanitary No.
i s Date 56-„'x? 6 196_ Permit No./0 0 a /3 ?
_ o
OApplication is hereby made fora permit to NS T R U Cr S T�A6tw
c
i
in a story,Type A/? Building
< w
to be occupied only as inAcordance with
0 o Plans, Specifications and Plot-Plan filed herewith.h.0 PI Ck Fee
Estimated Value of Improvements, S Fez S
zJ 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
2 o Cupertino will be compli d with. a�a�
3N Owner - 5 ��14Nsd�e Address /6180 M AY A46
W
a B Address
<u Phone .a `7� ;;t Y 7, 7 ApproveAVILLIAM D. BENEVICH
(r State License BUILDING INSPECTOR /