51114 /a�ga 2&� .,59
LOT NO.
NO. STREET
w 2 APPLICATION FOR BUILDING PERMIT
, M
CITY OF CUPERTINO
R _
0 ' Samtary No. `
50 /
ILL
Date 196_ Perini[ No.
o ,ohm/
LL Application is hereby made for a permit to
o a r
i In a story,Type Building
to be occupied only in accordance with
0 o Plans, Specifications and Plot-Plan filed herewrt�a PI Ck Fee
F ; Estimated Value of Improvements, $ 11 Fee$
i 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
J O Cupertino�willbe pli with.
3 `a Owner Address
— Z
La
a By Address
O FI 3—70 2-e
`U Phon L Approved
-'-- State-LICenSrv -