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1884 r?c© 7 1 b / I I/"'r.�-Qi LOT NO.
NO. STREET
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO r p
Date _ ��% 195 - er nit No dJJ
Application is hereby made fpra)�rmit two
a_ story,Type l ��i R 'Id' a
at /
to be occupied only as I: G
in accordance with Plans, Specifications and Plot-Plan filed herewith.
00
Estimated Value of Improvements, $ © — Fee$ 'IeL. /CES
� It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
all other laws aaacable to the construction, location, and use of buildings within-the City of
„j Cupertino w 1 complied wi 7
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Y Owner' Address -
IIy Address
CONTRACTOR AGENT
Phone — '� Approve
BUILDING INSPECTOR
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