51167.2/- F/7" e57YC Ci LOT NO.t� 7
Nn...-:.. 1.S7�E$•T 1 6 � ,Z
e XP�LIGA►TION tFOR BUILDING PERMIT
f tJ U N 6 19��CIT� �tOF CUPERTINO Sanitary No. _ 6
Date - •>� r^a 19,6 Permit No.
Application is hereby made for a permit to %
a story, Type S c 1 Building
to be occupied only as , S e ., in accordance with
Plans, Specifications and Plot -Plan filed herewith. PI Ck Fee
Estimated Value of Improvements, $ Fee $ ,�7 s�
It is hereby reed that the requirements of the Cupertino Building and Zoning Ordinances and
all other la�plicable to th onstruction, location, and use of buildings within e City of
Cupertino w 11 b complied wi .
Owner Address 9 �
By -
Phone % Approv
E//
State License // • �� BUILDING INSPECTOR