51099.1 (2) pp�p�J/ Lor No. Z p
H a NO. �rY�� �Jk �� 4
w PPLICATION FOR BUILDING PERM
O MA 1.
a R 15CfT�80F GUPF.RTINO S 7S'�F
o a Sanitan� No.
s�
W Date 3rd nr �••�r196 � Permit No. spa
o w V tf( 1 r
o Application is hereby made for a pe in 49 C_V
a ��� ,
i a O N�- story,T �l Building
aW
t(,be occupied only asv (Q in accordance with
a
0 o Plans, Specifications and Plot-Plan filej herewith. PI Ck Fee
Estimated Value of Improvements,S r O O•� . Fee$ 1 O�• 00
iJ It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
* = all other laws applicable to the construction, location, and use of buildings within the City of
J O Cupertino will be complied with.
<
- '4od -4 hoax
m Owner RO / �0�/t T Address
a Address
a I , hone g6Y' 7�4 7 APProv
State Licens' tq/ �JQ DING INSPECTOR /
X