861 (2) -T STREET
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APPLICATION FOR PLUMBING PERMIT
dITY OF CUPERTINO
Date195_ Permit No.
III Fee $ 'e:2-0-6—
Application is hereby made to the City of Cupertino for a permit to install plumbing
1j 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 a plicable thereto.
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Use of Premises
1 Owner Z4WIV Address
_ Address
Phon
3390 THE ALAMEdI�cEIST Approve
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Cupertino Sanitary
Office Copy
BUILDING INSPECTOR'S\ I
OFFE -C
CITY OF CUPERTINO A-'rS"
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Sewer Connection Sanitary Permit No!*-
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dumbing Final Plumbing Permit No. ".. 6-./. ............
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Owner or Tenant IV.QR�.........
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Tract .......................... .7L....
DateConnected ..........................�Sl- - is-------------__..-...................................
DateFinal ................................ ....... .......... .... .. ....._............. 19.��...
PLUM6ING INSPECTOR
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