2715 aa3. f�flc�Pi/.��s/�iE oizdE LOT NO.
NO. i PLRT Q FOR PLUMBING PERMIT
a Y OF CUPERTINO
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?APR
27 1964 Sanitary
0 LL< Date f�/�•PiG �3 196Y Permit No.No.
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W CITY OF CAPER`"
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0 Application is hereby made to the City of Cupertino for a permit to install plumbing
o a pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
i N and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other laws applicable thereto.
LL Use of Premisescas cfPr ey,
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o a Owne[�E�`f'G'GiF�F / rJELOF�iyEil/J Addresssl0
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,Address /?D. /57 S/r'i/JTigC'GA.C/7
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CONTRACTOR, AGENT
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a o State License Approved6t/ -4--&
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O, PLUMBING INSPECTOR
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