100064 � 0 �71 Pte.
LOT NO.
NO. STREET
w z �A PLTIC'ATIgy FOR BUILDING PERMIT
Y o "-1 OF CUPERTINO
2 Sanitary No.
° < (DEC 15 1965
5 Uate 196— ermit No. /06P 64;z
o r
�. F ^y�pplic Qn IsfhFt7b�atad� Permi[to
a lIl i f lilJr I(
n a story ypek'x ' Building
to be occupied only� Ar I: e with
0 o Plans, Specifications and Plot-Plan filed herewith. PI Ck Fee 44& P
00
F ; Estimated Value of Improvements, $-/d&40 Fee$ q
oa
z 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.
Owner7nID /uC Address
a By ��al'o m Address
07
a U Phone .-7 C - 7�'7-2 App
A roved 'r
,f State License_���� ��' e we INSPRCT00.