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NO. ST HT J
�� APPLICATION FOR PLUMBING PERMIT
z i N,U �J {' •`i ON CUPGRTINO
n o %)YI I Sanitary No.
3 a Date/D �,5zv 8 1963 1963 Permit No
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wL, '--,/ (�[ (� rR ; �• Fee $
o Applicdtio5ris hdrIb m-ade'to the City of Cupertino for a permit to install plumbing
o a pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
i and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other I ws livable thereto.
I, Use ofPremises
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Bldg. Dept
Office Ccpy
BUILDING INSPECTOR'S OFFICE
I
CITY OF CUPERTINO
F� Sewer Connection Sanitary Permit No. .c�...
Plumbing Fi I Plumbing Permit No .[;�..---...
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Owner or Tenant ..: ................_*........-_.�.�'S�. ........._....�,... ....�.el............
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Tract
Date Connected .. v -- .1d
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Date Final -------------------------------- I --- ---
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PLUMbINNSPG �O
III 7/63-1M
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