NO PERMIT NUMBER (3) 136T I IYY a, A_ NII , I.OT NO. � I /G��
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NO., I Y ��
APPLICATION , FOR BUILDING PERMIT
` O ft FIR A 1968 CITY'OF CUPERTINO
KLL
o � Sanitary No.
W Date Tsr - 19&/_19 Permit No.
'o r Application is hereby made for a permit to : ,�
a
'z a a I story,Type s Building
aW
tl.be occupied only as in accordance with
00 Plans, Specifications and Plot-Plan filed herewith. PI Ck Fee
Estimated Value of Improvements, Z • Bim. Fee$ EL, 0 ZJ
O
J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
J Z all other laws applicable to the construction, location, and use of buildings within the City of
3 o Cupertino will be win I ed 'h.
- 0 Owner Addres
W 2
' a By Addres,�
ex
<u Phone��,S —0�10�/�S 3 Approved WILLIAM D. DENEVICM
State License$/ 7 ` / BUILDING INSPECTOR /