51064 NO. 'STREET AA
W = APPLICATION FOR BUILDING PERMIT
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CITY OF CUPF.RTINO
a LL o < Sanitary No.
Date 6_ ermit No.
° I�
`o Application is herebysa ,_�,Vpermi�t
,,n a CITY r stbkVt Building
aw �U
tt�be occupied only as a in accordance with
ii o Plans, Specifications and of-Plan filed herewith. Pl Ck Fee
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Estimated Value of Improvements, S TC7V Fee$
i J 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
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Cupertmovy9l be complied t
3 Owner c �' 7c- ' Addresses/0� "'�,•PLAP'�APlue"�i^'b
n By ° ` iO Address
u F N. A
Phone / aS��y / APProved
State License �7/�6 A V B6frDING INSPECTOR