483 I.OT NO.
NO, STREET
3 APPLICATION FOR BUILDING PERMIT
° v� CITY OF CUPF.RTINO
o i d Sanitarc No.
5_" 3
W „ U: t 3 196_ P mit No. X9
0 on Ishlg-�B a r a permit to
LL w
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a u: aly it Building
/ Building
w s t0 c upl on 'n accordance with
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a - ell
o 'o Plans, Specifications and Plot-Plan filed herew P'l Ck Fee
t', ; Estimated Value of Improvements,S k.�0 ,� 'g! Fee S&;.�U
iJ It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
J Z all other laws applble to the construction, location, and use of buildings within the City of
O Cupertino will plied
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a Owner Address
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W By Address
a 0 Phone y�d7.ti Approved
State License BUILDING INSFFCTOR