3030 (2) /O�/O �-I L% ri✓✓'� LOT NO,
NO. STREET
W APPLICATION FOR BUILDING PERMIT
pO CITY OF CUPERTINO
4
9 I Sanitary No.
5 �Jo �O
i a Date 196�'' erf'
No.-
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r Applic tion is hereby ma or a permit to
am astory ' T Building
W
W to be occupied only as
00 in accordance with Plans, Specifications and Plot-Plan filed It with.
00 T
W; Estimated Value of Improvements,$�� Fee$ 0 AE'C
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z J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
j z all other laws ap li ble to the construction, loi"tiop, and use of buildings within the City of
d o Cu ertmo will b c lied with. / -
3 'N/ pner�.c �� ndress
W
W a By Address
<u Phon O Approved
,� State Licen % DING INSPECTOR
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