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wAPPLICATION FOR BUILDING PERMIT
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° CITY OF CUPF.RTINO
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� fj� Sanitary No.
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o Date YI or 196_ permit No. f1/S O
o Application is hereby made b[a permit to
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aa �i r 0 IF stc Building
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r to be occupied only as rdance with
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0 o Plans, Specifications and Plot-Kan filed herewith. P1 Ck Fee
� ; Estimated Value of Improvements,$ CA iod5Q O�W Fee$354—
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
d o Cupertino will b c I'e with.
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Approved
`I State Licens DING INSPECTOR
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