295 1
N Nq. AM STAEE-' S
z ¢ ® APPL'I' TION FOR BUILDING PERMIT
Y o CITY OF CUPERTINO
o � N 2 5 1966 Sanitary No.
U a�'6
�11
I _ 196_ Permit No.
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o (al Application is hereby made or a eermit to
a
a m a story,Type�� � Building
w
a ; n,be occupied only as in accordance with
0 o Plans, Specifications and Plot-Plan filed herewith. PI Ck Fee
> W rrrti 3�—
~ ; Estimated Value of Improvements, 5 dOO Fee S
iJ It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
J i all other laws applicable to the construction, location, and use of buildings within the City of
d o Cupertino I be co with. .
3 < Owner Address
a a BY AdStem
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° F _
a `0 Phon 2 T
Approved a
,I State LICenS LDING INSPECTOR
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