1025 I Ck R O%-) V\I t +`It L _ LOT NO.
NO. STREET
�) 'A al tFOR PLUMBING PERMIT •
/JAN 23 1961 ; OF CUPERTINO
Date I l� , Ig ov Permit No. b ?"a
CITY OF CUPERTINO Fee $ �� S
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
q Cupertino, and all other laws applicable thereto.
Use of Premises- /,4
Owner „o `menti (// r� ' Address
gy � 3.. 2 �tc Address/4c
CONTRACTOR, AGENT
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Phone C� ? 7 Approve
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PLUMBING INSPECT-NR �
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D O k w y O O N p O O O y H
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Cupertino.sanitary
Of'tekopy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
F-1 Sewer Connection Sanitary Permit No. .... .........
Plumbing Final Plumbing Permit No. -..7 -------
Lot No. ..... ----------
Owner or Tenant ----jeWe�
At ----
Tract -----------
Date Connected
- --- - ----- ----- ------ --- ------ --
..........
Date Final .. . .....
---- --
- ------------- 191/0
MBING INSPECTOR
ttl 1/60.500