403 y� LOT NO.
NO. STREET /
z �
APPLI�ATI N FOR BUILDING PERMIT
to
° fl-TWOF CUPERTINO
o < I Sanitary No.
I
S U 4 t,(
W o Date ,I �� g196� Permit No. / 3
W W Application is hereby made for a permit to
i In a CITY _Qf stotyl,y{ty�ei�-PI t �'"�4'��� �fLGA Building
to be occupied only as� ��ii�L'—r� in accordance with
0 o Plans, Specifications and Plot-flan filed h with. P1 Ck Fee
, ; Estimated Value of Improvements,$4 O00 —' Fee$ ,ZE
i 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
2 O Cupertino will be co plied with. ^„ ' „ ^
3 i Owner 7_C_r/73 Address 1Q G p l' llt/
N ' /
W W By Address 1 (rte
us
`u Phone c;W - 3 z/� Approved
II State License/Z- 2 3 BUILDING INSPECTOR