1720 I1 11&(W I l Q^ ok- \_it - LOT NO.
NO. STREET.
�17L CATION FOR PLUMBING PERMIT
CITY OF CUPERTINO
D(}�G 0 962
19(—!— Permit No.
//��II DDrr T nn Fee $
M ITY A p7icatC6LI sFhOg'7tmnde to the City of Cupertino for a permit to install plumbing
bN 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.
Use of Premise/5�s�cerci
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Ii Owner r�° Address `
By /,"/ O'_ Address
CONTRACTOR, AGENT
PhoneV/14)
7 y 7 APprove
PLUMBING INSPEC R
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Bldg. Dept.
Office Copy
BUILDING' INSPECTOR'S OFFICE:
t' CITY OF CUPERTINO
t`
❑ Sewer n Connectio �47'/ .C... _...
,,. ,,,... Sanitary Permit No. .......... ... ... ...
' X Plumbing FinalPlumbing Permit No. ..� / -
s O i
Owner or Tenant
At .../ - ..
-- ------------------
TracC
4` - ._...... ..
i, DateConnected ---- .._............_
-- -
Date Final ---- ---. �� 00
19.h..,'p._.
4
PLUMBING INSPECTOR
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111 7t-500