51181LOTNO.
No. STREET
z < �AP,PLICATION FOR BUILDING PERMITa Z .�
__� `— luu
r ° CITY OF CUPF.RTINO
o 1.5 ��5� Sanitary No. .03 ,4
5 U fDEC//
Uate ,�/�lPi 196 Permit No. .f_//6%
~ O r rr\T1R'ti / /
`o a rj Applicat on if hereby madgfo_ra permit to
N a C?7LP story' Type `� / Building
r ; to be occupied only as tf%'� in accordance with
a
0 o Plans, Specifications and Plot -Plan filed herewith. PI Ck Fee
> ; Estimated Value of Improvements, $_ 2/ 00 Fee $-------------%/f/%
iJ It is hereby agreed that the requirements of the Cupertino Building and Zoning rdinances and
J Z all other laws applicable to the construction, location, and use of buildings within the City of
o Cupertino will be complied with. DI1Z-CRANE
3�
_ ,a Owner Address 22 DE RI 17 pt wn�
W n BU SAN'. RA, C
y�t;r. -
a U Phone`/"��/J�� Approve
State License /.--/��% / IN\ INSPECTOR /