1895 LOT NO.
APPLI AA1TQI,O-N �FQR PLUMBING PERMIT
N � le/Vy
W Z IA.P! ` aW7Qr cvreRTlNo
x o �"'-- Sanitary No. r '
3 a Date Z.� Permit No
c 11
wU v 1 1,.1
= LL Fee $ /!9r
o 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 ti
* r and fixtures in accordance with the provisions of the Plumbing Code of the crty of
a w Cupertino, and all other laws a plicable thereto.
g u Use of Premises
00
N
o a Owneeee
/f - �75/1 e - C R Address
agy f' i f'/!a 5 Address %223e, S;'
3W Phone. — -1s-
wZ p
ao State Licens Approve
_U V ONTEACTOE, AGENT
® —
{/ }
.. z
� Z000
§ a \ \ #
F ( (/ $ E
; - -
w
Bldg. Dept.
office Copy
BUILDING INSP#CTORIS OFFICE
CITY OF tUPERTINO
=-5�er Connection Sanitary Permit No. ....-`I9..... ....o
2--I�fumbing Final Plumbing Permit No. .....
LoNo. ......................
Owner or Tenant ...............................
...... ... ...
.........
....... .....
At ...................,9.-b.. .....
..... . .............. W4
........... _ .... . ....... ..........
Tract ................................
Date Connected ..........................
- .......................... 19..
Date Final ..................................
..... ...... ............. . ....... . ................... 19..
........... .. .............. . .. . . .............
PLUMBING INSP OR"
111 7/61-500