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1086 1Dy �o _ S LOT NO, l7 NO. ST FOR PLUMBING PERMIT • Yti'R 4 1�`y OF CUPERTINO Date 3 1SdY Permit No. CUPERT Fee $ CITY, OF. Fee $ Application is hereby made to the City of Cupertino for a permit to install plumbing 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 Premises_ y Owner 2 Address By r . AW Address CONTRACTOR, AGENT co Phone//41 7� _ Approve / PLUDIEING INSP TO _ --------- -- --- - _----_—___ _-- N w Q M N rj n1 � � •�' '+'1 "/* N � H H 7 V' O O O � N Q w o 0' o _____ „-_ __-_-_ y__ Cupertino Sanitary. Office Copy BUILDING INSPECTOR'S OFFICE CITY OF CUPERTINO //ryry// ryry ❑ Sewer Connection Sanitary Permit No. ...,1[i..fPryrySF.............. [Plumbing Final Plumbing Permit No. .��lF.r........... 'In of No. ........" ............... Owner or Tenant .... - : ...!4!. ... .. ... . .. .. ........... .....-�..------....._.. At .._1....Q� O...------ .moo..�u�l--2t.........................._.................. Tract ............. . . .. ................. .............---............................................................. DateConnected ..... . .........................../ ............................... ........................ DateFinal ....................................../ ........... ...................................... ............ . .... ............................... ._.' iP bfBING INSPECTOR 111 1/60-500