1859 ';2'cax I Y!l\ LOT NO.
NO. STREET
Ut� FOR PLUMBING PERMIT
&,'NOV
!TY OF CUPERTINO
19 1962
Date—I/ -/L 6 ")— , 195— Permit No.
CITY Or CUPERTINO Fee $
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
i
Owner 1*/Lh c r31 Lir 1,. Address
By/&,( Address c '-1
CONTRACTOR, AGENT
Phone G/ youi 7 9 Approved
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Bldg. Dept.
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
C] Sewer Connection Sanitary Permit No.
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Poeplumbing Final Plumbing Permit No. -14:-------------
Lot
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Owner or Tenant ......
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Date Final ------------------ --- ------—O 10- W --
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PLUMBING INSPECTOR
III 7/61-5oo