311 .d-'-dam �--E, .✓ r7o .nT N . � 4�+ rya .
NO. STREET
z ¢ rnON FOR BUILDING PERMIT
r ° �AP t F CUPERTINO
o a /R � 66 'hmtary No. 3//
5 U VU /
i 0 Date L er o.
� o
App] cat
OF ade Fora permit to �r EST 2� S45/()
a �
z Un a story,Type
_ Building
aw
w to be occupied only as20 iordance with
a
00 Plans, Specifications and Plot-Plan filed erewlth. PI Ck Fee
/ o
F ; Estimated Value of Improvements, $ (ism Fez S L G
zJ It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
J i all other laws applicable to the construction, location, and use of buildings within the City of
2 o Cupertino willbecompli d with.
j aXC/� 4rLC-/4T
_ Owner Address
Address 1T2�Er/GY S✓t
io Phone r �91'�F+ .3/
YApproved
yd— State License WELDING INSPECTOR