1162 10292 r Norwi'. va- LOT NO.
STREE72or", 7W
NG. APPLICATION FOR PLUMBING PERMIT
CITY OF CUPERTINO
Date March 21, 19St_61 Permit No. to 2
• Fee $ 1 -90
•i Application is hereby made to the City of Cupertino for a permit to install plumbing
pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
N and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
Cupertino, and all other laws applicable thereto.
Use of Premises residence
.d
u
Owner 0. A. Wayne Address 10292 Norwich Ave. Cupt.
By Address S07 Tht ATamcrl c T
CONTRACTOR, AGENT
Phone CY 5-3435 Approved
PLUMBING INSPECTOR
9CH � ol � � 0n W OTo Rri�g a
w
,� w w ^ to �, ❑ � k '.' n p ^ �._ .r°. ^ M
°' m F.. ❑ y. T w cn
M �
O N
a — --- --------------- -
a b £ n r v n a a U z a a a y
0 0 o w �'
nN T
olr
p 9M� dC7My _ .x2 � c5w ym =
z