1775 1.� E ,Q�/S LOT No. .J
® F LRIQN FOR PLUMBING PERMIT
TY OF CUPERTINO 7
Date 1AUG 3 0 149% . 19 .4" Permit No. / 7 7
CITY OF CUPEff INQ Fee
(_ Application is hereby ma e to t e City of Cupertino for a permit to install plumbing
l 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 laws applicable thereto.
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Use of Premises
hOwner ���"r' '� `°" Address Azc '" '
By �� Address ' A (dP
i CONTRACTOR, AGENT
PhonApproved
PLUMBING INSPECTOR
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Bldg. Dept.
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
Sewer Connection Sanitary Permit No. .. ...tl..::........
Plumbing Final Plumbing Permit No./.7,J- ...........
._.;:Owner or Tenant -...... ...... -
At o�/.S"7.. w
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Tract ... ........ . ... ��........................................
Date Connected ................. . ......................... ..................... 1 L—
Date Final ..............................::../.....�'�.. ...,..' .. ........-...........-.. tl ...
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PLU BING�kINS E R
Ill 7/61-500