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1 P ICATI�N FOR BUILDING P IT \�
CITY OF�CUPERTINO ''
Date_ : 195_ Permit NiO 4�
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Application is Iereby made for a permits"&tele f
r ` a story,Type Building
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to be occupied only as
m accordance with Plan pecificationJs and Plot-Plan filed herewith. o-O
. \ Estimated Value of Improvements,$/ ✓C� Fee$
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c: It is herebyagreed 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
Cupertingwilllbe complied wit
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OwnerF�'� Addres / _ 1 IL4YY
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By Address z'
{ / CONTRACTOR, AGENT
Phonel^D o —� � Approve
Y BUILDING INSPECTOR
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CERTIFIC �i OF C M�� tE. I1 N
BUIL N INSPECTOR=S FFICE
CITY OF CUPERTI O '.
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Date ......!. .... ,=3......------ .......... 19.1 y%.. Buildi g Permit No. ...r'. a..........
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The Building Located at ._//•' G' �•............. �.':! -`.e-'w�........_.......
Owned by n,
.................... ................................ .........._.......................
� (Completed)
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Has Been (Altered) For Use As: ......5... ^ �"
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.............................----.................._...............'..........----........................................---....---........
............_.---------- ..........................._...................-----'----............._...............
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BUILDING INSPECTOR
102 7/59-500 /