51118 / 8 Pry
No. Street Lot No. �SO
1 J UN 2 6 rp5ACA-ON�FOR BUILDING PERMIT
City of Cupertino
�//��'' Sanitary No.
-� DateCT'NO Permit No.
E Application is hereby made for ermit to CI " fY+t—A
m c PP Y P
3° a .Z story,Type Building
tom, o to be occupied only as Bedrrson Sfv 1 in�dance with
° °' Plans,Specifications and Plot-Plan filed herewith. PI Ck Fee �0
`c° m Estimated Value of Improvements,$ Fee$
o `o [t is hereby agreed 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
0 Cupertino will be complied with. _
.3 2 Owner �� p�!/,(/_S�j,!/ Addres
m aci BY aSiO/rl�
c Phone 2�3�3'l'9� Approve
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State License Bu Inspector
t