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14MAY APPLICA R PLUMBING PERMIT
111960 ` OF CUPERTINO —7
D� 195_ Permit No.�/
Fee $ lO'
Application is hereby made to the C,ltj+;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___
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Owner /r 1 fi?k!U '` Eo Address
By �. S 1# LfjGKGA111111111k Address F3 N- /;1�` fi�w Sy SL
CONTAACTOft, AGENT
Phone i� ' 7 y S _ Approved
PLUMBING INSPECTOR ,
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