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NO. STREET
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R i�' PP6ICATION FOR PLUMBING PERMIT
No I- OF CUPERTINO
}. Date �WU 5 .;- nTl �Il95_ 'Permit No. ef
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 -'
v
Owner ../ ddiess
} Address
t 3390 74E A�AR�E[PFiENr - '
+ Phone Approve
PLUMBING INSPECTOR
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Cugei'tino"'Snuary
'"'Office Copy
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BUILDING INSPECTOR'S-O„FICE .wi°
CITY OF CUPERTINO
❑ Sewer Connection Sanitary Per .1.}ds ,.. `--: ......-.
Plumbing Final Plumbing Permit/9.Vo:,..1�41f ._..:....
e.^
Owner or Tenant ... .__. ./��....... ... ..... ...... .....� .. -" �-- -------..
At ---- D_3"I-------- . .. - .................. .... .. .........
Tract ................ .�.� .-
Date Connected --------------------------------
Date
----------------------------Date Final ----------------------------------
JMBING INSP17CfOR
111 1/60.500 _