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APPLICAeTIOR PLUMBING PERMITrl-
nOCTT 3 1961 CUPERTINO p
Date�.,._.Y�_'�C.Tr�6 fft" 1&5_ Permit No. 42 / Q
Llr t v� IrUI ll"I Fee $- 1:7' SC)
�t 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.
t u Use of Premises
Owner /\ P` F1bK4k�-S AddreAaO CAMi3,219GLs
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PLUMBING INSPECTOR ,.D
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Cupertino Sanitary
Office Copy
Ap BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
❑ Sewer Connection Sanitary,Permit No. ....,.���h�...._.
g�Plumbing Final. Plumbing Permit No. --./ 90 '
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Lot No- ---- -- ---------
.. Owner or Tenant ....:���.!...1_.,,-,\' .
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Tract --------------- � ....... _
Date Connected 19.... - -- .. '10 :
Date Final -,.................................
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x .�jPLUMBING INSPECTOR
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