51145 (4)ria ya
6
LOT NO.dI2// /x/177
NO. STREET
.A� PPL ICAT rONI FOR BUILDING PERMIT
r o CITU OF CUPERTINO
S i ID F„ 14 1967. Sanimn' No.
W w Uate 3 196.2 Permit No.
iii ys.
'o
w
lCApplicatibnisRie6y(oFd f6iCa,,permitto jERLES T
o � est t r yr vu. � Ir
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a story, Type Building
w �r �� I✓M/N K
ato be occupied only as C '✓ems.e/ e in accordance with
0 o plans, Specifications and Plot -Plan filed herewith. PI Ck Fee------`�-��.
F ; Estimated Value of Improvements, E O -Y .+e Fee jS�:�
iJ It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
* z II other laws applicable to the construction, location, and use of buildings within the City of
o Cupertino will be complied with.
<,�4OwnerL//a-i. le Address-2/-SO4Ho.✓ra/,.vim.
w z I/1
a a Byz !2e rTse.Q/ Address I-'/ri fc iTe /�✓. -S .T
0 Phone �/ r� Approved
j�_ State License 1 y�/�/L�/ BUILDING INSPECTOR