51113 11�171 {Z�C (�O\1 `\`� LOT NO.
NO.1 N . SnEE STREET
wAPPLICATION FOR BUILDING PERMIT
F O
x OF CUPERTINO
S2LL ® �
� SaNtarl' NU.
U
_ Uat196_ ermit No.
D f a
'o Application is hereby made for a permit to
iin ai ffi[st[{r}{[[� Building
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I, be occupied only as in accordance with
0 o Plans, Specifications and Plot Ian filed herewith., ___
PI Ck Fee - .__
Estimated Value of Improvements,S_'sOG iii Fee a 3
iJ 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
d o Cupertino will be complied with.
3P n:C;pf`
Owne1q�JC L. . �'� t?� kP 4- Address
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I By
< 0 Phone u zz 7 60 A rove
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State Licens BUILDING 1NSPFCI'OR