51099.1 (2) 27-1 M2c� � ..s 1�
�j OT NO.
N ✓ �A�PL C'ATIO� FOR BUILDING PERMIT
o MAR ] 5 196$ Cl3"YI OF CUPF.RTINO �u 3 13�
Sanitary No.
7
5 — S/1091 /
W Date —I I 196 Permit No.
x10
4 w wnERTdN0 Zee r'
o Application Is he ermit to
�y. S- I - S
i a a (S/t�1G story,Type Building
a w V-D (Q
to be occupied only ashX in accordance with
ii o Plans, Specifications and Plot.Plan fil d herewith. P1 Ck Fee
"; Estimated Value of Improvements, E Cm e0 Fee$ 101. 06
i J 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
o Cupertino will be complied with.
3 � lr! Address s tdi
_ N Owner A
W a B,� (PLx{2'_ Addr 1 / r
uE 11
P one 9b 9 7 1' �/ 7 Q Approve
State Licensef5/ /So /� BUILDING INSPECTOR
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