51167.2LOT NO.
NO. STREET—
42rP6iC=ATIO1.1o1� FORS BUILDING PERMIT
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}Y� CITY OF -CUPERTINO
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W Date ` C//!%E 196� Permit No.
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o W Application'is Hereby inadeYoll'�tpermlt to &HC07—
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Plans, Specifications and Plot -Plan filed herewith. P1 Ck Fee
Estimated Value of Improvements, $ O Fee $ S S O
It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
all other laws applicable to the construction, location, and use of buildings within the City of
Cupertino will be complied with.
Owner /
By
Phone a
State License S 1991
Address
Approvecl<-,rv, I I ng1 n -i rTrr,.I7y�
BUILDING INSPECTOR
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