567 / O 7-
No. STREET
z ` APPLICATION FOR BUILDING PERMIT
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/% -' = --� CITY, OP CUPLRTINO
3 `
"r SanitarN No.
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w ,� Uate - '�'1'�Y 1 IS5�
196_ Permit No.
ao77
o � Applicatio . hereby made for a permit to
<m a l �"stoiy,TY.P eIt • • - Building
i,J
r tube occupied only as / o ` r�tJn accordance with
0 o Plans, Specifications and Plot-Plan filed herewith. PI Ck Fee
Estimated Value of Improvements, $� y
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z J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
J z all other laws applicable to the core ruction, location, and use of buildings within the City of
2 o Cupertino w' I be cum lied with.
3Q
— w Owner ddressfe3' @7
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By. Address/Gc�-��/'9e�e-L
a o Phone �-]�Z' 9 `i7
—u —T Approved —
State License BUILDWG INSVECl =NIGH_