51134 'QV4 I /040
Z I .
NO. STREET
w ¢ If L 0 OR BUILDING PERMIT
r ° I F CUPERTINO
aSanitary No.
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QV 1 1967 .5tDate 1 1967 Permit No.
ro
o AfIiYo ffhe ftPERTI O"T"t to
a 111''YYVV
i to a story,Type Building
to be occupied only as Sg be d 17y U t"K S in accordance with
00 Plans, Specifications and Plot-Plan filed herewith. PI Ck Fee 7 —
� ; Estimated Value of Improvements, $ 0 n 0 a-o Fee$ /S J a
i J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
* = all other laws applicable to the construction, location, and use of buildings within the City of
o Cupertino will be fompI d•with.
3 Owner ill be
lYlv9- Lf FcrciAddress 1
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a a By -1rs1y' c4le 0- &.—CA Address
01 a U Phon �S 3 Approved
State License BUILDING INSPECTOR
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