2364 QOe 9 8 Q,;Q tL1Q_ + 'LOT NO. 99
NO. STREE
APLI L)TION FOR PLUMBING PERMIT
CITY OF CUPERTINO
' AUG 21 1963 I- ',
Date C��CsUsa ly I 19ta- Permit No.
r :TY OF CUPFRT'"'
Fee
N 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
aatt Cupertino, and all other laws applicable thereto.
u Use of Premises QQ2id2ACe
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N
Owner��Tn��a rm pier �u Address Co nPbel►
By_ r'1JYd 'p�J end _ Address CG . bell
CONTRACTOR, AGENT
Phone Approved �✓ ti1 G�
PLUMBING INSPECTOR
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