1464 LOT NO.
NU. STREET
APDL CS�A bkOT OR PLUMBING PERMIT
Ch F CUPERTINO
R 2 Ina i
Date 19�[� Permit No.
CITY OF CUPERTINO Fee $ / �" 5=
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 applicab2thereUse of Premises
v
Own Address
BY Address
CONTRACTOR, AGENT 7
Phone Approved
PLUMBING INSPECTOR
w0
& nz
o C
n w ^w O
Z
y
in 7
0 0w
alp
Ml
Bldg. Dept.
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
❑ Sewer Connection Sanitary Permit No.
- -- ---- w
----- -----
G�Xiumbing Final Plumbing Permit No. /TTOT
Lot No. ...d. .�.....-.-.._....-
Owner or Tenant ..--
At
------------ ------- --r
Tract ---........
Date Connoted ......--.. ....... - .Z
. ......._...... -------- 19-
Date Final ---. ....--...-...............-.-.�.17 -._. .._.-..._---.. 19.4 Z
PLUMBING INSPECTOR
111 7/61-500