1759 LOT NO. J
;f NO. STREET
&\'AN4�L'ICI'/4TI0N FOR PLUMBING PERMIT
.x `CITY OF CUPERTINO
f'AUG 27 1 .
Date Igd'2! Permit No.
CITY OF CUPERTINp9 Fee$�QO�
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 - A"t' tai
Address
BMIW SOFT WATER SERVICE, Address
1040 L*WF4C57wea"W4 Approve
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Phone Enb'all'La� f..ni, _
PLU BING INSPECTOR
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