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APPLICAT16WTOR PLUMBING PERMIT
w Z �%r CITY'OF CUPERTINO
Fdi AY 1 `� 1963 Y
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3 a Date 196 Permit No. 0 7 7
� o - oY Iii 11�.1fL.1'�� \th Fee $ el a0
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
'z N and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
w Cupertino, and all other laws applicable thereto.
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3CONTRACTOR,AGENT
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a o State License 7�y Approved
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PLUMBING INSPECTOR
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Office copy
BUILDING INSPECTQRIS OFFICE
CITY OF CUPERTINO
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ae'�;wer Connection Sanitary Permit No. .......s...............
0 Plumbing Final Plumbing Permit No` .v
Lot No. (,9..Z�..........
Owner or Tenant .......
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At ............
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Tract ....:.........
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Date Connected .................................
.... ............................ ........ .............
Date Final ...
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Ill 7/61-500 PLUMBING wspEcr6pl...