835LOT NO. :;7
NO. TREET ,
APPLICATION FOR 'BUILDING PERMIT
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OF CUPERTINO fi
Dat ff1� - 195_ Permit �N'
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plrOdp�il is+herd r �pe�t to ��� �'?,
a / story, .1ype v
at CITY OF CUPERMGG
Building
to be occupied only as
in accordance with Plans, Specifications and Plot -Plan filed herewith.
�n DO O
Estimated Value of Improvements, $
/OC / Fee.$s;�_-
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It is hereby a reed that the requirements of the Cupertino Building and Zoning Ordinances and
all othec applicable to e c s
coon, location, and use of buildings within the City of
Cupert o eco plied it
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Address/D..J/V
By
Address
ONTRACT R AGEN
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Approved
Phon O
BUILDING INSPECTOR
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