51167.2 PERMITLOT NO.
STREET'
T �-y ' ►PP69 t WIFOR BUILDING PERMIT
Y °A�i N �5��; dI .t OF CUPERTINO
X-
o Sanitary No.
i LL Dare a- v --- a 196-Z Permit No.yff'//` 2. Jo
o , , t. a
a Application<is hereby made for a permit to
oQ
zz u) a %WO story, Type _ Building
a W �. > 62
to be occupied only as in accordance with
0 o Plans, Specifications and Plot -Plan filed herewith. Pl Ck Fee
F3 Estimated Value of Improvements, $ SZ.. 000 . Imo, Fee $
z J 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
O Cupertino will be complied with. /-
_ �, Owner Address
w z By ��i9��/%C
Ct a /ef'��• Addresses
a o Phone—
_ U J Approved
State License / _ ��/ BUILDING INSPECTOR f�