943 790 6JX LOT NO.
NO. S�TREET
jiaAV I,CT
ON FOR PLUMBING PERMIT
OCT 2 0 1960CITY OF CUPERTINO
Date �
, 195_ Permit No.
o, CITY OF CUPERTINO Fee S /ll' .Jd
Application is hereby made to the City of Cupertino for a permit to install plumbing
0 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 the etS1
Use of Premis u
Owner—/1' N Address 1
By0NIVF4)A4- SPI?INk4A`E `1 _ Address O 9 1/6 ►9 NSJ - S.7
CONTRACTOR, AGENT
4 Phone C`�' 3' �I �� G �/ Approved
-IF 1�/�� '� PLUMBING INSPECTOR
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