51117 (2) / LOT NO.
w APPLICA 1 FOR BUILDING PERMIT
p ° IFSEP 24 1965 `� of cupraTiNo
0 , Sanitary leo.
1 o U:rtq 196_ � 'ermit No.
TY OF CUPE
r lr�
o F Application is hereby made for ermit to
a
i in a z story,T .".) /O /S Building
a w
r to be occupied only a in accordance with
0 o Plans, Specifications and Plot-P led herewith. P1 Ck Fee 7`5:0-m
Estimated Value of Improvements S 00 Fee o0
0 P �� S /e5
oa
z J It is hereby y a reed that the requirements of the Cupertino Building and Zoning Ordinances and
8 9 P R
J z all other laws a icable to a cons «ion location, and use of buildings within the City of
0 Cupertino will be plied wi
3Q
,a Owner h' Address
Wa By r Address
` 0Phon � 8 7/ Approred
State Licensr4rme BVI.KING IN5PECl"Oa