51022 � (/�' � Oat
Z //� --);Fadb y �f LOT N0,
NO. STREET
w APPLICATION FOR BUILDING PERMIT
ti o CITY OF CUPF.RTINO
g Sanitary No.
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Permit NoSI0Z.Z
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° 09
4 w A plica JNN on il h re1y ade r a permit to
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oa
i na� storl`r' 1"`61M
to bei be pc" ctipied"dnly aAa ALW Mk i thOriance with
00 plans, Specifications and Plot-Plan filed herewith A Pl Ck Fee
> 0 Estimated Value of Improvements, $ 2 Fee$ li
z J It is hereby agreed that the requirements of the Cupertino Buildi and Zoning Ordinances and
z all other laws applicable t the construction, location, and use buildings within the City of
d 0 Cupertino will omplied nh.
wOwners Address S �r
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i
By _07
(} �j Addres
0 Phone �� A s'
o PPro
/ State Licensttg d l0
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