1660 (2) a ► —_ Z LOT NO.— �`T
IFJL&P'L I lyo�ic 'OFR UPRNOPLUMBING PERMIT
Date eakBO pE"095_ 'Permit No.
Fee $
Application.is hereby.made to the City of Cupertino for a permit to install plumbing
pipes an or fixtutes''listed'on the reverse side hereof, and agrees to install said prices
and/or fixtures iq.a, ordalice with the provisions of the Plumbing Code of the City of
Cupertino;,and"all.otfi.e flaws applicable thereto.
yy9 �Se.: ,.A,it
Use of Premises +/ 1
Owner �37
4�ts— Address —
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, w..By 4// Address" t
CONTRACTORj'AGII :1
Phone R—n 7-3'V'7;7i' Approved
PLUMBING INSPBC R
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Bldg.,Dept.
Office Copy
BUILDING INSPECTOR'S OFFICE,
CITY OF CUPERTINO
ry
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Sewer Connection Sanita Permit No:-.`:..[X.�.
' [1�41umbing Final Plumbing..Permit No:::.21;W .40..::..
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Date Final ... .;.......`............ - - : .•....
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PLUMBING i
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PLUMBINGi INSPECTOR `
111 7/6] 500