51192LOT NO.
N kJ�o. W3
�t� APPPPLICATION FOR BUILDING PERMIT
° APR 15 1968 � 1TY OF CUPERTINO
o i Sanitary No.�� C
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W Date �,C196 Permit No. _IS Z / V .2�
0 1..,: i l lil uus ....:..
W Application is hereby made for a permit to
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i w a story, Type — Building
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n. be occupied only a� v accordance with
0 o Plans, Specifications nd P Plan'4fed h//ere , th. oo Pl Ck Fe
Estimated Value of Improvements, ire Oo0 — , Fee S 00
i J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
., Z all other laws applicole to the construction, location, and se of bd i It the ty. f
J o Cu ertin ill eco phrh.�_
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Owne •Address
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It a By Address
07
<U Phone — /p Approved WILLIAM D. BEI`MVICH
State License/ BUILDING INSPECTOR
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