1514 o r
LOT NO.
NO. 0 iV
TD APPLIC FOR PLUMBING PERMIT
I APR 2.6 1962 OF CUPERTINO
Da eny Ur �(('�j�,��j�J 11>v— Permit No '
.� V Feee'$� �• l
1 Application is hereby made to the City of Cupertino for a permit to install plumbing
�l pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
' and/or fixtures incordaWL' �n with the provisions of the Plumbing.Code of the City of
Cupertino, and all er laws
\ap'pllicable thereto.
ry 1
Use of Premises t'�M t ��q0
[ Own r Address pp�r/ r
By r bi£ v f c _ Address xp�1' /4 �L l•LL�ier�.vu
I ONTAACTOR, AGENT `1 I B.
Phone�X 57 )Q9/ Approved
PLUMBING INSPECTOR
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