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N a PZP�LIC IONJOR PLUMBING PERMIT
w o �� -0 1963 � �� " Sanitary Nu.
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3 a Date 196 Permit No
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� o t{ �� r� �Pr ^1.n Pee $ J . 00
Applica ion I hereby med? to the.City of Cupertino for a permit to install plumbing
`o pipes and/or fixtures listed on the reverse side hereof, and agrees to install said ,rices
i 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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w se of P raises
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✓J PLUMBING INSPECTOR
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Uidg. Dept
9tii:e Copy
BUILDING INSPECTOR'S OFFICE
CITI' OF CUPERTINO
❑ Sewer Connection Sanitary Permit No. . `r�...�..`.�.7...............
Plumbing Final Plumbing Permit . ..........-
C,// Lot No. ...... -�.:,::............
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Owner or Tenant .. _C- .rs:.a:•-- :. -'^- -i4 ` :�
At _____�__O__ (..x...... ......
Tract ................................ ..-._:... .............. G......................................r-
Date Connected --------------------------_t......------. ' ...y -- lY'.........
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DateFinal .................................................3. ...J`..-----1•-....I!...............-. . 19-#,(.....-
PLUMEING INSPE O X
11t 7/63-IM