1649 LOT NO.
NO. � '� y�RP.E IC R PLUMBING PERMIT
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I CUPERTINO
JUL 20 196
Date 2 C) , I 19k� Permit No.
T CITY OF UPERTINO Fee $ / 9
M
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 PremisesPS
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By S1 tri 1' I /cmc Address .i d 2 v� r/inr is er
CONTRACTOR A�GSNT
Phone �L — q 0 O _ Approved—c
PLUMBING INSPECTOR
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