51129 / 16 � Le_" LOT NO,
NO. STREET
3 APPLICATION FOR BUILDING PERMIT
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OF CUPFRTINO
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O QS:Inita rl' No.
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Date Fermit No.
o 5•p rmit to a � �� Building
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to be occupied only; in accordance with
00 Plans, Specifications and Plot-Plan filed herewith. P] Ck Fee
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; Estimated Value of Improvements,
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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
O Cupertino will be complied with.
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_ <n Owner�'ilYrS d5i��/GJGyer ii Address c�0fS �eir
as BAddress
<U Phone ¢ Approved
State Licensr �3 `� - 9 BUILDING INSPECTOR 11'
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