2189 -2o 6-5-(I -_. ... LOT NO. l��
APPICATI
LO PFOR PLUMBING PERMIT
w i 4 JUN 20 19MiTY�OF CUPERTINO
x o Sanitary No.
0a Date r P6�nG'Qi;'19713 Permit No r
i o Fee $--z
'- Application is hereby made to the City of Cupertino for a permit to install plumbing
o` a pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
i(n and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other laws applicable thereto.
L Use of Premises
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oa Owner ,/ /Jy✓/.1/CG C.GCII Address
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WILLIAM D, BENEVICH
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^n_State License r�6 U.��"S Approved
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Bldg. Dept
Office Copy
BUILDING INSIECTOR'S OFFICE
i
CITY Oq CUPHRTINO
F� Sewer Connection Sanitary Permit No. 3�.L.9-77............
......... .. ..
E)--<timbing Final Plumbing Per7 it No.
..........
t No.,....44 L1...............
Owner or Tenant .................... .... . . .. . ... .....
At ...........
..... .................. .... ..... . .... .. ................................
Tract
. .. ............ ... ------ .......
Date Connected ...... .......................-....1...-----1-77......--- ------
pp
DateFinal .................................
. .........
PLUMBING INSPEC OR
III 7/63-1M