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NO, STREET CO�`
W T a �PPt:ICATION FOR BUILDING PERMIT G J
E °
r � TY OF CUPF.RTINO
M a Sanitary No, SS�7 7/�iC
W Date rn
A� 1 5 r d 196f Permit No. S/ 99•f
Zo
o CIT%ft iEeti hereby made for permit tg AC�? G
iur a dN��stbrtll' Building
to be occupied only as !f I 1C innaccordancence with
20 plans, Specifications and Plot-Plan ew th. PI Ck Fee !
9'1 3ED2
> m '—
Estimated Value of Improvements, $ Fee S ! 03. 00
iJ It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
.a Z all other laws applicable to the construction, location, and use of buildings within the City of
o Cupertino will be complied with.
3Q
Owner 4T N -0. Address �
W z n/3 �' [ t�- Address
W W �y
°u h �_/ 6O $r 7 61. 7 Approve
° Phon pp
State Licensed'/ 75'v 9`/ 7 au INO INSPECTOR
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