100060 LOT NO.
NO. STREET
N
w Z PATION FOR BUILDING PERMIT
;< ° "r � TY OF CUPF.RTINO0 < Sanitary No.
U196 Permit N0
o W Application is��h��e{{r�}ebby/p�made�for a permit tos�G� OL, 4�
or
a� a�ay-y--I---�t—¢S'iY1FL)1Re4iiY&: Building
a ; to be occupied only as in accordance with
0 o Plans, Specifications and Plot-Plan filed herewith. P1 Ck Fee
O 19
Estimated Value of Improvements,S_/A O Fee$ a c"_0
iJ 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
d O Cupertino will be omplicd wt h.
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— 0 Owner�fLIC Address/Z O ave
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4 U Phone 5,302 — 2 9P0 Approv
1 State License ILDING INSPECTOR /