51167.1Y
LOT NO.
APPLICATION FOR BUILDING PERMIT
,CL 'CITY OF CUPERTINO G'F
Sanitary No.
Date- rr.. lop I M9 Permit No. S//67,/
Application is hereby made for a permit to
a r1TkInrr:stQry�p.T�l��n y�/J Building
to be occupied only as Sin accordance with
Plans, Specifications and Plot -Plan filed herewith. P1 Ck Fee
Estimated Value of Improvements, S a�ODD Fee E
14 is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
all other laws applicable to the construction, location, and use of buildings within the City of
Cupertino will be complied with.
Owner
By
Phone -��/%�/�/�Ask
State License—
I
Address L01Z-CRANE
22 3 VC LA LKUL 51
Address SANTA rt ADA -
WILLIAM D. BENEVICH
BUILDING INSPECTOR
V