2184 DG f%sr I _ V LOT NO. Y-`
Q:{� sTR.APPLICATION ,iFOR PLUMBING PERMIT
w2 IJUN 20 196�1TY_ 'OF CUPERTINO
x o Sanitary No.
p LL C,
3 a Date //PRC' .t^CyI1�CD'"�iq6 Permit No O
i LL Pee $
/ - a6
aw . 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 m` and/or fixturesIlin accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other laws applicable thereto.
w I)'Oa4A al m,�'O
0 LL Use of Premises
00
31 //
3 Owneer�r%2?Z q� f4m?JjC 6,/y Address �/137�� a�7
BY Address l/�/U�//h_/✓_/�
3 0 ONTAACTOR, AGEN
- an Phone
W 2
W w
State License C3& 1/39S' i Approved WILLIAM D. SENEVICH
rLumEtNGiNsrEcroR
O o W a w N o w m
.y ,t7 ro v w _.
�. UO ". n H r n � w � G ro ^ ?� �. O' f/� � S S n S m G n S -�. �• -
r d A W o
w 0 7 G v R �• N N �• O H. 7V' A W N 0 A N vGi 8
:4 ^
•J� �" Il N
S t*1
n .w Wiz
Alm
Wz M
[M1 A ox_ v n > o o n ^ Q o 0 0 n
H H9 g o e 2 n � `n-1 raron �
Ota-.' ,�v d C7 ,o '-I = Sd "� a. w O � � ^NT•b ° �,
' w r
o
M z z
N
N
Bldg. Dept
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
❑;See Connection Sanitary Permit No. ......3... ..........
,7 r
Plumbing Final Plum 'ng Permit No.<--?, -�.&�4..........
Lot No.......Lp�................
Owner or Tenant ................ ---- -
.
. .. .......... .... -.................................
At ---- -----
Lp . ...... -------------
---- -------------
Tract 3 "------- --- —, . ------W -.............-.......
Date Connected .................
---7---J.---7.......................................... 19—
Date Final
. .. . I 19 ..............
............. .......... -&-- I . ...... ...
II 7/63-IM
PLUMBING INSPCT