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N APPLLIICATIOF`.OR PLUMBING PERMIT '
W�
AUG 3 0 1962 c�F CUPERTINO _
n Date -� LA Ir. C 1 f1.9 — Permit No. / 6 3
\ V od
\ Fee $ /7
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
�j and/or fixtures in accordance with the provisions of the Plumbing. Code of the Cityof
Cupertino, and all other laws applicable thereto.
S/��,
Use of Premises C -
:a _
h Owne Address
By 1 / Address
ONTAACT B�jAG/E,N7 /
Phone�� r y - _ _ 'Approved
/ , / PLU BING INSPECTOR
UNITS
Vawes
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Fee
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Bldg. Dept.
'Office Copy
BUILDING INSPECTOR'S OFFICE
CITY Or CUPERTINO
Sewer Connection • Sanitary Permit No....... -------
Ey-"Plurnbing Final Plumbing Permit No.
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t Noy ----- .......
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Owner or Tenant ........------- -- --- -- -------
At ----- ..... ...
------ ----
Tract ----------------- ...
Date Connected .. . ................... -------- ... ffX V --- ------ ----- ------- ----- ..... . 19.4
Date Final ........................ .
---------------- - ----------- ---------------- I9 ---N .....
---- -------
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. ..... .. . .............-
PLUMBING
............ -
P —IN PECTOR
111 7/61-500