51145 (3) 4a�
(6B/ / ( 7�z¢� T LOT No.
w z APP'AC—.PP FOR BUILDING PERMIT
s 0 F�DEC
01 OF CUPERTINO
oa 21 1 65 Sanitary No. S
SU �—
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Date—(�[ (� —DLr 19f>� Permit No.
o CI ypliedt$on Qu e iFyfbi a permit to 2. 1e— —r
i N a � story,Type Building
ato be occupied only as ���!` /l�/�i�t/ NSG j n accordance with
0 o Plans, Specifications and Plot-Plan filed herewith. PI Ck Fee
F3 Estimated Value of Improvements, $, 2� /7a9 Fee$
o c
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.
3 r�//,�11 �ii�+� �G�`.i<✓,.>•fi.�=Address
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Owne ,
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Ma. By Address 3
UPhone �F3—Ofd
- /y Approved
State License����5 BU NG INSPECTOR