51028 OT NO..2 o 66 l I m v y T .Sa iMY7s-lf
/ NO. STREET
N Q
3 ® OR BUILDING PERMIT
s O l�11
r „ �JI CUPF.RTINO
0 , 1 Sanitary No.
_ UatePR O 965 1 ;196 Permit No. J I O 2
o
w Cdt n re et It to / f 01) 1 T I o% -/
ApQli
i N a story,Type �r Building
t..be occupied only as BPd 1'CO Wy' npaccsyiance with
go Plans, Specifications and Plot-Plan filed rewlthPi Ck Fee l _
Estimated Value of Improvements,$ Fez$
zJ It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
J Z all other laws applicable to the construction, location, and use of buildings within the City of
d O Cupertino will be complicd with. L v'4_StI 'A-tJ
H Owner �� 1Z C• { C �oTT ILZ Address �el4y al A nlcy Cr
W
a By A DI t-1 I; At W-1 'Address)bU'� 5➢ZnT•6n So n,ylbnn's
- O Phone
U S {.y O Approved WILLIAM D. BENEVICH
State License/ ��' -Z BUILDING INSPECTOR