51130 ZO ?J / I Y _/ I tetrec IAT NO.
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APPL"KATION FOR BUILDING PERMIT
° APR jgs£CITY(=OF CUPERTINO
o < ���jjj + Sanitary No.
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Date ae 0.
w —-- L96i Permit No. S 3
'o Application is hereby made for a permit to
a
i In a story,TyAV'e P&410- Building
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to be occupied only as in accordance with
00 Plans, Specifications and Plot-Plan file herewtt} Pi Ck Fee
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Estimated Value of Improvements, S ✓ Fee E kS��
iJ 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
o Cupertino will be complie with.
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— 0 Owner r'r PO At/ Address f y s a
W e By q �' Address Ir
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4 0 Phone Z" J� L y9'? Approve
State License ?--/ Z— 6 /7 BUI DING 1�