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W Z APPLICATION FOR BUILDING PERMIT
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Y ° CITY OF CUPERTINO
° a Sanitary No.
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i LL Date Permit No. --S—,// e3
0 W � is h(vet�7dormit to LIA—e—O aa story, Typ� "//� // Building
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to b�it�ie��ly �s v� j S in accordance with
0 o Plans, Specifications and Plot -Planed herewith. Pl Ck Fee
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; Estimated Value of Improvements, S 35-0 X10 y Fee $ /d Ei '0 L'
zJ 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
O Cupertino will be co lied /with.
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Owner Address OwnX ST4a d a •-d Ut �o r
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a a By If, �itit ,�a ��, / TC Ste-; Address �.f i .f 3 ��/Ivc Ou +<e4
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State License /f L B LDING INSPFCTOR