51122 (2) LOT NO.
Na NO. CSTR
W AfPKICATI0 f, R BUILDING PERMIT
0 0 ►A R n 196SI�E��CUPERTINO
Q 4
a Samtary No.
5 O s/�a
w „
Date
oZ 196k Permit No.
° Q� r��oF�TINO.
o w Application is tierebyn ale f r a permit tci
i m a Z story,Type- �9 �C�» _ r/ /�. Building
a w
to be occupied only as in accordance with
20 Plans, Specifications and Plot-Plan filed herewith. PI Ck Fee e,2 7, 0-0
> m -
Oo
Estimated Value of Improvements, S r Q Fee$ J7�
iJ It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
J = all other laws applicable to the construction, location, and use of buildings within the City of
a Cupertino Wil be compli d vith.
3 A.
< Owner i r Address '0��o91 L Gda
Q. By
aU Phone 01 r �cens25/�' �v2�� Approved
WILLIMA D. E+E•NEVICH
rl StatLie a �y—�— /
1y BUILDING INSPECTOR