51069d/
LOT
NO. Six e,�i
® A'PPLICN FOR BUILDING PERMIT
ITY OF CUPERTINO
tOCT 19 1965 Sanitary No.
Datel/ 1962
r Permit No. �Q
CI IAYppI ion &REP d Q, a permit t�L"' '; /!
a `1-- story, Type
to be occupied only as
Plans, Specifications and Plot -Plan filed herewith. O
Estimated Value of Improvements, S tis eP 6 Q' .
Building
in accordance -with
P1 Ck Fee
Fee$ /�.°b
It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
all other laws applicable to the construction, location, and use of buildings within the City of
Cupertino will be complied with.
Iwill
By _;:�y14d C , /
State Licens*-7-V STI:I— Ar
—
3y
/ 0 / r �- , - ., a,,
NO. STREET
yZAR�4I;CATION
Y OF
Dare OCT 1. 9 4 [96_
LOT
FOR GAS PERMIT
CUPERTINO
Permit No.
J T41icpt r in�?tRt R (he City of Cupertino for a permit to install gas pipes
an /or gas ap lian eYY s e reverse side hereof, and agrees to install said pipes
and/or appliances in accordance with the provisions of the Plumbing Code of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises
Owner h _J�y6.tJ S L RE' A dress
AGENT
State License A 7 j 7 Approved`�`�w
r PLUMBING IN SP EQ A
of Appliance I Units Fees
E TYPE
HOUSE GAS PIPING
Number of Outlets Size of Main
Gas Piping Fees
Tested and Approved ............... ............
DATE INSPECTOR