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NO.1STRBP.T
*' APPLC' N FOR: PLUMBIaN,G PRMi •
� OF CUPEAtINO'
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Date 195_ Permit No.
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.
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Use of Premises
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Owner Address
JO-E�-.l_ PLUPABING, INC. Address • �—
$j4§OIY}'R9QIJOH�.RGENT
Phone SANTA CLARA, CALIFORNIA T Approved
PLUMBING INSPECTOR
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BUILDING INSPECTOR'S OFFICE
CITY OF,CUPERTINO
❑ Sewer Connection Sanitary-Peunit No. J-k"-.
Plumbing,Final Plumbing Permit No. ....!!-..
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Owner or Tenant 1-7
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Date Connected ............................
Date Final ------ -- -- -
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111 1/60-500 ULUMBING INSPECTOR