51139 �D6 L C �7rifC/ / IAT NO.
NO. STREET
W APPLICATION FOR BUILDING PERMIT
, a
p CITY OF CUPERTINO
f LL
p J Sallltar\' NO,
i O nn �
LL ` 196_ Fermit No.
Date 7
o
`o Application is hereby made for a permit to
i in a story,Type _ Building
to be occupied only as c or ce with
0 o Plans, Specifications and Plot-Plan filed herewith. Pl Ck Fee �Y
F "; Estimated Value of Improvements, $�crc) Fee$/� A42
ia
J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
J Z all other laws applicable to the construction, location, and use of buildings within the City of
O Cupertino wiA be complied wit
3 �
Owner .��-C�� Address OE1_C �PnFileo ��/r
wZ
It a By Address
U PhoneI52 - 2u$ � Approve
State Lice ns LDING INSPECTOR
�X