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STRE
-APP Ih�N1 FOR BUILDING PERMIT
C• OF CUPERTINO
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Date 1 195Permit No.
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Application is hereby made ffor a permit /
a_ —story,Type U " ` �' Building
` at
to be occupied only as
in accordance with Plans, 'eci6cations a dd Plot
t---Plan�{id herewith. _ry Ur
Estimated Value of Improvements, $,/ �' ti:'wv v. Fee$ c1� / "—'
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� It 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
Cupertino will be complied with.
Owner I 0— - Address
N � G
By �IAd& Address
/ CONTRACTOR, AGENT
PhoApproved
BUILDING INSPECTOR
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CITY OF C 5 tO
120111
Date .... 9-
............................. Building Permit No:,.
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The Building Located at
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Owned by --...s.-/......_..... ..."..............'? . _.
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(Completed)
Has Been For Use As: ...-.---� r�
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BUILDING INSPECTOR
102 7/59-500