880 NO. into.
ST
JAPP�IC FOR PLUMBING PERMIT'
Y OF CUPEDate: A , N5_ Permit No.
Fee $
Application is hereby made to the City of Cupertino for a permit to install plumbing
j 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.
Y
Use of Premises
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Owner Address
JQBCJAMARAL --UMBING, IN '.
l Address -
3390 3bi6k
Phon4ANTA CLARA, CALIFt)�MWx
T Approved_ 1$�L' ! 0 4 l i
PLUMBING INSPECTOR
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Cuaer ,w,Sanuary
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO a r'•
Sewer Connection
❑ Sanitary Per
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Tract -------------- - -.... ...•....-_... --------
Date Connected .....------....----- --- -/�i! ------------- 19 -
DateFinal ----------------- ----------/ ...Lp...::-.....-.. ./-----------------+.......
P�[ M81NG INSPHCI'OR
11 I 1/60.500 -