2461L •` % I OQ" �'`�-V-(,1L� /—I-C�Ce,/ LOT NO.
NO. s"EF.T
E
- IA�
CTO FOR PLUMBING PERMIT
CI OF CUPERTINO
OCT 25 9963 Sanitary No.
Date Tg .1p� 'rr� T, 16_ /Permit No. 62 L_/
I1' I t X D (i15 1 1 t�11� Fee $ �. Ct U
Ap Cain D ere i � 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 fixtures in accordance with the provisions of the Plumbing Code of the City of
Cupertino, and all other llaaaww/mss applicable thereto.
Use of Premises 'k-W';f
Owner %/��/,�htF-v
By<f c C�Lc
NT OR AG NT
Phon —?3S—
State
Address
Address /'3=) lel /-ie(/ih(ti-rte
Approved
PLUMBING INSPECTOR
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