51039 N
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W Q A LICATION FOR BUILDING PERMIT
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° CITY OF CUPERTINO
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° a Sanitary No.
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W LL Uotte • l Permit No. % 1039
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0 W App a4 �he�eby ��for " mit to 1�
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Q In a_� a C.Y.r�CJ Building
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to be occjt g on - Rte�,a4ith
0 0 Plans, Specifications and Plot-Plan filed herewith. Pl Ck Fee
r ; Estimated Value of Improvements,$ d45 Fee S 0
iJ It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
* Z all other laws applicable to the construction, location, and use of buildings within the City of
d o Cupertino will a complied with.
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_ N Owne Address
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�� State License [ 03 — 70,V' DING INSPECTOR /