2078LOT NO,
APPLI IATION_FOR. PLUMBING PERMIT
'nG
CITY OP CUPERTINO
ra -- !MAY 17 1963 1.� Sanitary Na.
O a Date ' % — 1963 Permit No cil 7d
CITY OF CUPERT "' Fee i��s
O Application is hereby made 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 in and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other laws applicable thereto.
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.. Use of Premises /
00
o3: Owner l/l_�rr-� _¢./ Addres
ZJ
zBy`G` Address
o CONTRACTOR, AGENT
3 uai n,
W
ao State License ��a 7yI Approved. k—
U PLUMBING INSPECTOR
ME
-I'I�INI -,MINI,
Bldg. Dept.
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
n Sewer Connection Sanitary Permit No. ---�otq -------
'[Kurnbing Final Plumbing Permit No.
Lot No. ----- 1957 ....
Owner or Tenant ---- ----- -------
44!
At
Tract ..........
---------- ...........................................................
Date Connected ------------------------------- 106-7.;,7
---------------------------- t9-- .......
DateFinal ..................................... .............................................. 19-63-
. . .. ................... * - -------
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'1 17( rr
PLUMBING INSPECTOR
111 7/61-500