51028 LOT NO.
NO. STREET
w a ?NOV
e PP-CICAT`ON FOR BUILDING PERMIT
ITY OF CUPF.RTIN
- r' fit. v No.
1 965 196_ Permitk. M02. 2"
w
Date
0
s'llgge
01 ^I tioot� or a permit to
z m lay- �sttorry,, a Building
< w e
to be occupied only as %*fte with
o 'o Plans, Specifications and Plot-Plan filed rewlt PI Ck Fee
F ; Estimated Value of Improvements, $ � Fee
i J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordina y,
* Z all other laws applicable to the construction, location, and use of buildings within the ityVof<;j/t
J o Cupertino will a complie wit 7 ,
< Owner Address A 040.4
0
wZ
a gy Address
i o Phone M � 1 6G�
_U p� rov
\ State License WIRR�// A PP
10� BU o To
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