51114 1y4 O Z� V OL�gfl VlJ• a86
LOT NO.
NO. STREET 'I
z APPLICATION FOR BUILDING PERMIT
' M
OF CUPERTINO
Sg tan' No.
V ^ S � I �
i a Date196erml—t—No.
° Re T
4 Application is hereby mad for a permit to
oa n
z In a Qw.1E story, Building
w i . t S�MOm
to be occupied only a C'ASL ZOOMS M V�.5�•�RTJ056Lcordlnce wl
0 o Plans, Specifications and Plot-Plan filed herewith. PI Ck Fee
F "; Estimated Value of Improvements, 5�b ,.-Qono. Fee$
i J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
Z all of laws ap licable to the construction, to ation, and use of buildings within the City of
J O Cup tin will b om lied with.
3 < ow erg'• 00 �t �tTa
i . Address CO
a 1) Pho r J APPro
I I S ate Llcens �� BUILDING INSPE 0