1351 /Q / b �5 LOT NO.
NO. STREET
APS CAT[bC--lTY
N FOR PLUMBING PERMIT
REC OF CUPERTINO
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Date , 195_ Permit No. 13C511
y CITY OF CUPERTINO Fee $
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
y Cupertino, and all other laws applicable thereto.
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Use of Premises—
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Ownert`2PnL '.�QSG�ci Address
By Address
CONTAACfOR, AGENT
Phone q 2 ' X90 C Approve
PLUMBING INSPECTOR •
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Bldg. Dept.
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
L] Sewer Connection Sanitary Permit No. ---------
941,`i?l=bmg Final Plumbing Permit No. -----------.....--`----
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PLUMBwNG-
- INSPECTOR
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