51130 IOT NO,
NO.. TREET
w APPLICATION FOR BUILDING PERMIT
t �
r ° CITY OF CUPERTINO
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o a Sanitary No.
5 U
i LL Date 7" 196C Fermis No.
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n Application is hereby made for a permit to
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i to a story,Type � ,Q_ p Building
be occupied only as t Pa-�e� 6 '�'\ in accordance with
0 o Plans, Specifications and Plot-Plan filed herewith. PI Ck Fee
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>
> ; Estimated Value of Improvements, $ 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
o Cupertino will be complied with.
3 � Owner0f W'�1IrS . Jo�ePl �.N ! y Address�h�� e C^ �anG
W a BAddress /A
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-- State-LlcenSe - —B ING_INSPECI'OR _