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J OT NO.
NO. STREET �
W z i yAP ..LICATIO�N F`O�1IR� BUILDING PERMIT
r o CITY OF,IICUPF.RTIN0
No.-
0 < JUN 12 1968 . Sanitary No.
SV
Date -!i1'7 ��• 196_ Permit No. . 'S—/v e /, J....
O // rnlT\/ !1!"�/ It(`rn int.
n F Application Is hereby Itta�etfo�r a�ermto �i61 /A�.4Ll� �KliYjt,�
o a
z'in a story,Type_ Building
a w n L p
,w. to be occupied only as ._�(/e;�(Nlrrl ) SLI in accordance with
a
0 o Plans, Specifications and Plot-Plan filed herewith. PI Ck Fee
Estimated Value of Improvements, $c�[0Q• Fee$ ,Z
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
O
< Cupertino will be complied with.
Owner / Address/04e�
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3 lc..ao lG o2��
— w `n[�iS
W a By !/'1/iJL A7� / ' Address '/ ,
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u Phone�7y "n'�.36� q Approved "2&-" . /
State License U�� J / BUILDING INSPFCTO �
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