1855 NO.
NO. STREEY
ARP ACATION FOR PLUMBING PERMIT
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I Y OF CUPLRTINO
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' 0 Appht" isffebflii PT of Cupertino for a permit to install plumbing
'o a pipes a d r fix res Ii§ c6l o t e reverse side hereof, and agrees to install said prices
iand/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a m Cupertino, and all o laws appy lblc thereto.
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Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
❑ Sewer Connection Sanitary Permit No. ... .4-rP�
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[40'IPlumbing Final Plumbing Permit No. ../ �
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LotNo. _. ---....----....__.
Owner or Tenant -----
At
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Tract .........._.....
Date Connected ._.... -- ...._.....lo(. l/............ ... ........... ....... ---------.. 19L.
DateFinal _--.. ................ ��0 .. _.......-..-----....-------._ 19
PLUMBING INSPECTOR
111 7/61-500