51145 (3) I �iQGI/i� ,
LOT NO.
NO. TREET
w ¢ APPLICAT1,91 FOR BUILDING PERMIT
r o I Tjl OF CUPERTINO �� S
IDEC 21 65 Sanitary No.
s
i „ Uate - 196,E Permit No. .'5711 yZ' --
0
LL CA�ppljcatQ is t pr ?ERT1NQPermit to �E«
o � 1
a a story,Type Building
r to be occupied only as in accordance with
0 o Plans, Specifications and Plot-Plan filed herewith. PI Ck Fee
": Estimated Value of Improvements, $ -> O� Fez E � K
o <
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.
OwnerAddress
n By W Address -
o Phone d-
_u Approved
,state License But NG INSPECTOR L/