2362 aJLVb 1� • IAI.Q.d L�IN� IXAY� LOT NO.
NO. STREET
PQ 5IP LII TION FOR PLUMBING PERMIT
CITY OF CUPERTINO
AUG 21 1963 -
Date 1 1S6- Permit No. e2-3 CJ 2,
JAY OF C11PERT'"- Fee $ 0a
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.
th�
Use of Premises `I`�Pa �
:a
n Owner I Address�C1 v�Q1CQQ
By Address
CONTRACTOR, AGENT
Phone �- 8//I Approved_ 2-c ; C
Q) PLUMBING INSPECTOR
mono
rt
1 [*1
y
O tmn R7
O C C w N
O w
ko
W N z
Bldg. Dept
Office Copy
BUILDING INSPECTOR'S OFFICE
Cln' OF CUPERTINO
[-1 Sewer Connection Sanitary Permit No. ------------
Ej/Plumbing Final Plumbing Permit No. ...._..._
Lot No. ..... ..................
Owner or Tenant --- - ------- ------ ---- - . ........ .-Q-
At -------------- (-:1 "7 -
. ....... . . ........
Tract ............ .....
........... ------
.....ax,4p
Date Connected
Date Final ...........................
...................... -�p........I19-5
f`------ }..... - ------ ...........
PLMBING INSPE� OR
�,.j L.,
III 7/63-1M