1526NO. STREET,, '
I ON FOR PLUMBING_ PERMIT
AM 'c F CUPERTINO
Date 6 -6 • v S_ Permit'No /� (O
C
Fee $
/� o? %
- _ Ap�ll�tionQ herLtH�JISi2tT1diL�+City of Cupertino for a permit to•install l bing
pipes and/oF•fizt ees listed on the reverse side hereof, and agrees to install said prices ,
- and/or fi3tu'res:i accordancetwith the:provisions of the Plumbing Code of the City of
Cupertino, and all other laws applicable thereto.l/
Use of'Premises":
.a �— 7 �i �uaG�e u� A*
y
Owner ^ Address G�_�`
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By `� Address
I w } �CONTRAcl •AGENT
Y�' �°`yPhoneK"6 •} %—S (v 6 D t 9P'APProve
�, ;y' T ,t. �i `• •. ;�.,_T.Jp..'ts_ PLUMBING INSPECfOR•
}'_ 111.Y �_7".. � 1'::wl'c'...L 1 `� .� •1_:,'^_ :;:'I _"^ t. !. 'i f.. i
Water Heater , � / —O II I/`�I
Water Closets v �!Material, T� f
ns
•n ' 1 Bldg. Dept.
Office Copy
BUILDING INSPE TOR'S OFFICE
CITY OFt PERTINO
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Sewer Connection - amtary Permtt No"".�"� 1
I'
Q� utnbing,Final bing Permit No.-.--�-5 >4z,
Lot No..---...J :,�
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Owner or Tenant ---- .-..`- .. —-- __.. _
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At-........l--- o.1._ck.
Tract ..-----------.._...-.-Q —
T-'...:....: ... .. .-------- -- ------ ---
Date Connected-------- ................... t... - _........_ .... ........ 19---
Date.Final.......................................
PLUMBING INSP CT R
111 7/61-500 0-f�--r .