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AP. LzICATION11 FOR BUILDING PERMIT
196�I o'ICUPERTINO
APR 15 Sanitary No. SIC?
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Date 196 Permit No. . V /-
Application is byma4deFP a pneimit to
a et2te— story, Type %-5-- — Building
to be occupied only4A;lc=- U�C._��accordance with
Plans, Specification4 and Wot-Plan gfd herewith. Pl CIL Fee
00
Estimated Value of Improvements, _-Ono Fee $
It is hereby agreed that the requirements of the Ct
all other laws applicable to the construction, locatir
Cupertino will be comDliirda ith, n
Phone
State Licenseo��%
BUILDING INSPECTOR
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