NO PERMIT NUMBER (3) '0216 LOT NO.
NO. STREET
CITY OF CUPERTINU VAL.
CAP. 1
APPLICATION FOR BUILDING PERMIT ( EEE - SZ
w Z ' Building Per.No. ,7
YO Dan, ,19-. Sanitary Per.No.
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O a Application is hereby made for aap�permit to LST-
3 v �
7 &
F 0—/—story, Type . T . Structure
O W to be occupied only as 3c/ - dtmww (�in jcco�dor6 with
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i Plans,Specifications and Plot-Plan filed herewith.
W Estimated Value of Improvements,$
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00 It is hereby agreed that the requirements of theL -�v�
yr Cupertino Building and Zoning Ordinances and all Fee$ d`
3 other laws applicable to the construction,location,and
Z < use of buildings within the City of Cupertino will be Total Fee$
Z complied with. 253 -/378
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w w OWNER PHONE ADDRESS
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Q OF CONTR.OR AGENT ,
PHONE STATE LICENSE DING INSPECTOR '
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