100153 I�np a NO. TREE
Z
¢ L�GATIION FOR BUILDING PERMIT
° N
Y OF CUPERTINO
LL
° a ® 1 Sanitary No.
96_ ermit No. /00 /S'f
Fo
LL w Application is hereby made for 'Mit to
1
'z a /'ITV Ftoty�� rJc, , ' Building
a w vs
o be occupied only a n accordance with
0 o Plans, Specifications and PlotPlaneddyherewith. PI Ck Fee u
" eo
: Estimated Value of Improvements, $ / OG Fee; s j
iJ 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
j o Cupertino will be complied with.
3P
_ ,a Owner Address
W a By 2 h e Pyr Address
°U �� X33 A rove e
a ° Phone PP
State License BUILDING INSPECTOR