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N 1 APPLICATION FOR PLUMBING PERMIT
wi 'NOV 8 79c�CITY!OF CUPERTINO
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, 0 Application is hereby made to the City of Cupertino for a permit to install plumbing
o a pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
iand/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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E State License 91 . Approved
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< o PLUMBING INSPECTOR
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Bldg. Dept
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
❑ Se er Connection Sanitary Permit No.'t t. 771:.#_._.........
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Plumbing Fina Plumbing Permit No.•r.J ( ,<$..;
Lot /No.!.. .�.:�:...-------------
Owner
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Date Connected .... . .........'• ....._�v-- ( - ---------
Date Final ------------------------------ -------------------i.. �� .. . ......_--.. 1 ..
PLUTIBI.IG INSPE�f`O .
111 7/63-1M ��