51182 X`t2 CJ LOT NO. 61S—
".,'�`CE- J' 6/
< A WN 1 v LIGATION FOR PLUMBING PERMIT
z ..
CITY OF CUPERTINO
W z
o Sanitary No.
3 -`PiTV /r/ 2�"w`-' .� 57 196' Permit No ���� Z
Uv?Date _ _
.wLL Fee $ -q J, J-Z
O Application is hereby made to the City of Cupertino for a permit to install plumbing
01 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
a w Cupertino, and all other laws applicable thereto.
0 o Use of Premises
o a Owner9i�L' \�— Address �&
_6 � >�iy/SDS - Qlt
ZJ O Q
By Joe Amaral Pin lne Address
o CONTRACTOR, AGENT
m Phone
w z _ WILLIAM U. E2EN =likC;S-1
¢ a
� E
o State License �7S'2�9 Approved —v
a
' —U PLUMBING INSPECTOR
61 �z ; < � ! /cE »
rH
§ i %\§) � \ƒ 2
E
m
«Izr, 0 r, 00c� � I\ ; m � < � ;
}( \ ( } �
! 7 ! ®
Tm
ƒ