1810 I V7 J LOT NO.
NO. STREET Ux
PRLI • Tf`N FOR PLUMBING PERMIT
® F CUPERTINO
�OCT 4 1962 / fro
Date _ Permit No.
CITY OF CUPERTINO Fee $-19
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
L° and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
Cupertino, and all other law pplicable thereto.
Use of Premises
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Owner �V ^ ' �1� Address
By f� + _ Address
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cINrancroR, AGE14T
Phone C�-\ X I qQ `�' Approve
PLUMBING INSP�
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Bldg. Dept.
Orta Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
[] Sewer Connection Sanitary Permit No. ... � �GZ........
Plumbing Final Plumbing Permit No. .fQ.(.(�
Lot Ne. .....
Owner or Tenant ---
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Tract .-------------- C�f' ........... /
Date Connected ----- ----.. . .. ----- �� ........._.......------....-.............. 19..�.Z
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Date Final 19 /
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PLUMBING INSPECTOR
111 7/61-500