NO PERMIT NUMBER NO. STREET
w = A PLICATI N FOR BUILDING PERMIT
f f �. L L
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r o Y OF CUPERTINO
5 < /1VUV 3p 1967 Sanitary No.
W Uate 196_ Permit No.
F O
`o a (.jApplica`�ton sO4 r bLpg1dletfor a permit to
' ff[[ �I
N a story, wilding
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to be occupied only as
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0 o Plans, Specifications and Plot-Plan filed herewit PI Ck Fee
F ; Estimated Value of Improvements, $ 404 Fee$
i J 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
o Cupertino will be complied with.
3 A
_ Owner �011ba, ! Ce. 1ne, Address
s u By �a 977i.<.�1/ Ad
� 0 Phone �9-s' ',>2�S�r/ APP rove
State License BUILDING INSPECTOR
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