1460 LOT NO.
NRAR� P.T
APPLICATIO R P UMBING PERMIT
' t�23 1962cl 1 r CCUPERTINO
Datei'94�L, Pernvt No.��`�G��
MM Vj Fee $
\1 Application is hereby made to theCity f Cupertino for a permit to install plumbing
pipes and/or fixtures listed on the revers side hereof, and agrees to install said prices
and/or fixtures in accordance with the p visions of the Plumbing Code of the City of
4 Cupertino, and all other laws applicable thereto.
d
Use of Premises
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/ v
Owner) Address
By slveti 110141 _ Address
5✓, �n CONTRACTOR, AGENT
/((__u"ss_vL✓✓h"'' t/ Phone _ Approved
PLUMBING INSPECTOR
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Bldg. Dept.
Off ire Copp
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
Sewer Connection Sanitary Permit No. ....._...
Plumbing Final Plumbing Permit No. ...,.//d.._...._.
/.'�'.'jt-----...---------
jOwner or Tenant
nt 10.6400*,
Tract szmv
Date Connected ------------ -------- ---- ---1f'.'. - .-(0..-----..-- ---...._--- -----...----- -------- I�
Date Final ----------------- --------------
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PL IBINC INSPECTOR
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