444 /0'/
LOT NO.
NO. STREET
N �
bZ
LII FOR BUILDING PERMIT
E
. 0
C W OF CUPERTINO
° i Sanitary NO.
S
i W Date V 2 2 1967 96_ 'ermit o.
0
o Application is hereb made f 'mit
In a LI Buil ing
to be occupied on
20 Plans, Specifications and Plot-Plan filed herewith. P Ck Fee
> W 00
r ; Estimated Value of Improvements, Fee E ca?�
oa
z J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
J z all other laws applicable to the construction, location, and use of buildings within the City of
d O Cupertin ill a mplcd with.
3 4 Owner 4 — Address
W . �.a6 4 c--
— N
W Z
a By ��� Address
4 Phone APP ro
F
State License L �f ILDINn INSRF.CTOR
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