2204 I � LOT Nn. 7
No. SrREEi
1
4', APPI.16AtION' FOR PLUMBING PERMIT
z a CITY"Oh CUPPRT[NO
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° a Date .: C - 2 O '// 196-3 Permit No. 1w2w
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° T plication is hereby made to the City of Cupertino for a permit to install plumbing
o a plpc`s and/or fixtures fisted on the reverse side hereof, and agrees to install said prices
r and�or fixtures in accordance with the provisions of the Plumbing Code of the Cityplf
e m Cupertino, and 'all other laws applicablGthereto.
w Use of Premises
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- m Phone -?77 SgS'Y/
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aState LicenseC C 7Z5 c7 '•Approved ' .k
PLUMBING INSPECTOR
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Bldg. Dept
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BUILDING INSPECTOR'S OFFICE
Cln, ul, CUPGRTINO
Sewer Connection Sanitary Permit No. --e...................
�1,mbing Final Plumbing Permit No. <z;>Go-q........
Lot No -- ----.7
----7- -------
Owner or Tenant ----- 0
At ------- ---- ---------(,- k��---------- - -------- -- -------------
Tract
-------------
Tract ----------------- - -- - - -------- ----- - -71-2-7.1-77--------- .. ......... ..................................
DateConnected ......... ---------------------------- ----------------------------------------- Iz.........
DateFinal ------------------------------------------ ......................... --------
PLUMBING INS C 'OR
III 7/63-IM