51003 (2) ** 9 vis
�no5-3 I M'e,feyr7 'bR LOT NO.
NO. STREET
w APPLICATION FOR BUILDING PERMIT
s �
r 0 CITY OF CUPERTINO
p LL
0 Sanitaiv No.
5 a
7— / 1965 Permit No. J U 0 3
ILL Uate —4Z
n Application is hereby made for a permit to (,
0 a
Z a story,Type q X z1r, Building
aw
w to be occupied only as / ate-E.�2+� ,C.wt-+..-+,..�..... in accordance with
oo Plans, Specifications and Plot-Plan filed herewith. 1 Ck Fee E,
Estimated Value of Improvements, $ 0 Fees Ae ;Z s.
iJ It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
J i all other laws applicable to the construction, location, and use of buildings within the City of
d 0 Cupertino if a complied wjJh.
NOwner �+-e-r--e-.� /l Address E J' ./✓7P'
a By Addr t
a 0 Phone
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State Licens BUILDING INSPECTOR