51137 �I LOT NO.
NO. STREET
w p APPLICATION FOR BUILDING PERMIT
r oA CITY OF CUPERTINO
0 _
o � Sanitary No.
50
W re , 196_ Permit No.
0 1 9� J
o r Application is hereby made for a OF
to
z ��IIT Building
w to be occupied only as C.../'�.t� in accordance with
0 o plans, Specifications and Plot-Can filedyherewith_ PI Ck Fee
F3 Estimated Value of Improvements, $ J to, Fee E
oa
z J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
* Z all other lpplica le to the construction, location, and use of buildings within the City of
O Cupertino illaws Etonicd
_ m Own Address
Z
By d Address - 7
< 0 Phon Approved /
State LicenseBUILDING INSYF.CTOR
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