51181I OT NO.
NO. STREET
w PWC�A7 (ON rOR BUILDING PERMIT
20 �EE1.4�jV UPF.RTINO
2 " ,
9 a 1 Samtarr \o.
U
i n
Date / J 24 1968 , Permit No.
0
o 1 �Ap_pli��is �ebyp'ade for a�r�m(i�t tol
iln a Zt story, Iylpell�L F/"' Building
<w
to be occupied only as _xz— in accordance with
20 Plans, Specifications and Plot -Plan filed herewith. PI Ck Fee
Estimated Value of Improvements, S �XL* Fee $ 5 /9 dD
i J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
* i all other laws applicable to the construction, location, and use of buildings within the City of
J_ O Cupertino will be complied with.
3�
— „ Owner Address
a p By
`U Phone
State LIC/CnSe�Approved
BOI IN'INSPECTOR