1792 '_ LOT NO. !S5
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�SP�tIIO R R. PLUMBING PERMIT
CITY OF CUPERTINO
Date CJTY;� C,CRTIPermit No. ( t
Fee $
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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 Premises
Crooner Address
By lU-� 7/��i/aTu> �c c Address t c e.k• - s_c� C
CONTRACTOR, AG
Phone_ �'6 /Y�7/,jcJ?CJX' Approv
1 PLUMBING INS CT R
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Bldg.,Dept.
office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO fY �j
[] Sewer Conn ion Sanitary Permit No. ... Q-//
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�lumbing Final Plumbing Permit No. 1./7 .7
Owner or Tenant .IY� ---- --
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Date Connected ........ ---------------------
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PLUMBING INSPECTOR
111 7/61-500 -