1623 A,-�V T,1 N F:. LOT NO.
NO. 11 STREET
�.
RUN
R PLUMBING PERMI I CUPERTINO(�7.07
2 7
1962
40
Date 5_ Permit No. / f' 2
CITY OF CUPERTINO
Fee $
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
and/or fixturesin dance with the provisions of the Plumbing Code of the City of
y Cupertino, and oth laws applicable there
d rr t i
Use of Premises 'C
Owner s u Jt t1oJ-ilz , n Address
-22(47
By7 _ Address
CONTRACTOR, AGENT ( '�
1/KI �Q
PhoneAPProv
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n ro o w y o 0
�d to
-� N
Bldg. Dept.
M
BUILDING INS\ CT0, R-S OFFLE- offI' copy
CITY OF VPERTINO !,I .,
❑ Sewer Connection Sanitary Permit No.-�144417 ..........
0!�'Iumbing Final Plumbing Permit No. 11e�01�7
..................
Lot No. . .... ..... .........
Owner or Tenant
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At ---- ---
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Tract ----------------- --- - -----
Date Connect ------------------------- -
Date Final ---------------------------------
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111 7/61-500 ---** --
�UMBING INSPECTOR