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NO. STREET
PPATION FOR PLUMBING PERMIT
® % CITY OF CUPERTINO
IN Ot / v
Dat / I-/ " e" 195-� Permit No. ( ���
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
Cupertino, and all other laws a plicable thereto.
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Cupertino Sanitary
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO y
❑ Sewer Connection Sanitary Permit No. ... ��..�... /..�..__...
Ewl—Plumbing Final- Plumbing Permit No. _4rQ91p
Lot No. .........l ----------
Owner
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Owner or'Teriant -
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Date Connected .................... ..........
.1 4 Y.. ......_.....- .... ..... .... 19`L
Date Final .---------_.----.:::^...... .
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nfB, fNSPECTOR
tit 1/60.500
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