NO PERMIT NUMBER (6)/07
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LOT NO.
NO. 5
C.,,, GITY OF CUPERT(NO
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APPLICATION FOR BUILDING PERMIT
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V ' "/S 78 Building
Per. No.
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Date/ 19
V Sanitary Per. No.
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Applicatjon is hereby made for to 'flK
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L _�a_�permit
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Structure
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a -story ,
to be occupied onlyas �f� %A/N /SJ_6 p' L�'
in accordance with
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'Z ,> Plans, Specifications and Plot -Plan filed herewith.
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Estimated Value of Improvements, $
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O O It is hereby agreed that the requirements of the
> 3 Cupertino Building and Zoning Ordinances and all
other laws applicable to the construction, location, and
OZ - use of buildings within the City of Cupertino will be
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w Z OWNER PHONE
PI Ck Fee $ to 1
16
Fee
Total Fee $ Zr
ADDRESS
O f CONTR. OR AGENT DDR 5
a ( 3�, J27/" a�Sis3
PHONE STATE LICENSE BUILDING INSPECTOR
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