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G�® I s �+ LOT NO. _
NO. '*r 6 BBT
APP KATION FOR PLUMBING PERMIT
CITY OF CUPERTINO
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Dat 1940 Permit No. t/
Fee $
( •'_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 r
and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
Cupertino, and all other laws-applicable thereto. t t
0
Use of Premises
u G _ O
Ow Aid yes 1.+•
By Bn� S Address �$
CONTRA OR, s HNT
Phone / Approv e..
v PLUMBING INSPECTOR
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P5 = §¥
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