288 I v-�aarI I.OTNO.
D s'lltegi' t
® APp�I'IYCA tlON FOR PERMIT
r ° DEC 13 1965 `C6 OF CUPF.RTIN
Q LL
O < 5anitary NO.
w 4 u�ltt Pe it No. �o D
° lel
o Application is ere y ma a for a permit to
< e
z to a 2: story,Type /yCi7/Y1 dY1 '/n, But. w
to be occupied only ash In a�rdance with
0 o Plans, Specifications and Plot-Plan filed herewith. Pl Ck Fee
> "; Estimated Value of Improvements,$ 4Z/2, 6O Fee$
i J It is hereby agreed that the requirements of the Cupertino Building and ning Ordinancrs and
J z all other laws applicable to the construction, location, and use of buildings within rhe City of
J o Cupertino will be complied with.
3P
Owner PIITtt Anlalrrnn Address
w i �� 1 1 IIIII I LIIJ
s a By ._._. ... .. _. Address
02 LLJUU 11. ❑LOIW"'a" nU.
<� Phone_n.�'_.u�� Mlif ]9g-4109 Approved
State License BUILDING INSPECTOR