300 �VfJAN25
STREET
` IAPPLICATION FOR BUILDING PERMIT
r0 1966 CIT--Y.OF CUPERTINO
o < / Sanitary No.
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Dat n: DTltvl�6� errmt No. �Fi('1
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a 0 vt t -
0 Q Application is hereby made for nit to /
i m astor a Bgilding
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w to be occupied only as / n
0 0 Plans, Specifications and PI6 Ian filed a it PI Ck Fee
F "; Estimated Value of Improvements, S Fee$ —
zJ 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 0 Cupertino I be camp I�' d with. 'Y cn
3 < ,4,t/ 4��f.�try Add, 14V ✓oJE
_ 0 Owner
a gy �1�OO12. S"/6- Address s }`�•
` 0 Phon 2�/" i3G� Approve
Ste L[C[n5e �'�/ LDING INSPECTOR
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