1961 ^-'"64T LOT NO. T v
u/ A P I� �L49N rNOR PLUMBING PERMIT
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W F ( I LaY"bF CUPERTINO
r p _ Sanitary No.
3 a Date "1 19� Permit No �9W
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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 �rices
> and/or fixtures in accordance with the provisions of the Plumbing Code of the Ctty of
a w Cupertino, and all other la s applicable thereto.
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a Use of Preses
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H 3 Owner Address
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BY Address
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.Q o State License Approved
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Bldg. Dept.
Offite Copy
BUILDING INSPECTO S. OFFICE
CITY OF CUPERT 0
0 Sew Connection I Sanitary Permit No. ....
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Zurnbing Final P umbing ,Permit No
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LotNo. .........................
Owner or Tenant ............... ..............
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At .....................
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Tract .........................:...........
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Date Connected ..........:..:.................. t
Date Final ...........
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PLUMBING INSPE OR
III 7/61-5oo