51022 1;2 S_ Lti Ao4( 4 c—Y LOT NO. 70
NO. STREET
wz APPLICATION FOR BUILDING PERMIT
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° CITY OF CUPFRTINO
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o a S:mitan° No.
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i LL llaDate !�/7//4/ter .2rJ 196 Permit No.
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'o Application is hereby made for a permit to <<��i�. r� �oo l
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on a story,Type �u X .2 D n2Ti1-At t Building
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to be occupied only as in accordance with
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0 o Plans, Specifications and Plot-Plan file herewith. PI ek Fee
Fstimated Value of Improvements, $ � 7e2 00 Fee$ 'Ai A&&a
z J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
z all other laws applicable to the construction, location, and use of buildings within the City of
d o Cupertino will be complied with.
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_ N Owner'�ti az Mn.r Address
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p a By Address
a 0 Phone2r� Approved
State License BUILDING 1NSPECI'OR
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