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OT NO.
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APPLICATION FOR BUILDING PERMIT
r ° �—')CITY
H
YF CUPERTINO
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to` No.
i Uarc J Vfn`c�4ral R 1QR7 •
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o < Application is herebyLFor aArmit to `�!G
ro a�stor T PC4riiJ.A_5�1.1�;. M�1A AJCBuilding
to be occupied only a* -A 7 7t4c C LAwl6lt'
0 o plans, Specifications and Plot-Plan filed herewith. -PI Ck Fee
Estimated Value of Improvements,s Fee
i J It is hereby agreed that the requirements of the Cupertino Buildin and Zoning Ordinances and
* Z all other laws applicable to the construction, location, and use ofif
within the. City of
d G Cuperon om with.
3 �
_ ,n Owner I Q Cam Address
WZ
W a B 11Address
i o Phon "� � PP
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State License OwwitA— BUILDING INSPP.CI'O
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