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1095 (2) LOT NO. �S►1 APR 1 aP1` A 1 FOR PLUMBING PERMIT b1 OF CUPERTINO U 6?nfolW, 141 Permit No. r Fee $ �6 �- 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 �1 Cupertino, and all other laws applicable thereto. Use of Premises` �6 ""'Y'7 Vv OwnAddress By ' Address CONTRACTORAGENT Phone A 1�� pprom PLUMBING�INSPHC OR > mr7 ¥ � 7 ` @E4 § gq § r � � em# �\ I 3 » � �_ � _ � # ( ( ( } > ; , ■ � ( � { � - _ PTI w + § E ! @ ` } [ 7 / ( r (� ; . � \ ® =------- � —k--�-------- -- � � ®~ ® ) ) xe ---- ---- ---------- ---} § \ r\ w1 } § E ! Ems # nK ; tee m � @e � 4rE ■ 2 $ I9 ( ) 01 \\ & c § 4 § A $ ---- — — ■---« -- � \ �-- ---- > � ` / k u Cupertino Sanitary O((icn Copy BUILDING INSPECTOR'S OFFICE CITY OF CUPERTINO ❑ Sewer Connection Sanitary Plumb Permit No. .....[..S1..SYpU......... g PlumbingPermit No. ..../0l..�----•- J� L'ot No. .---�'..�.............. 1 Owner or Tenant ...� ...ICY. .-----------.-....:. , At .. ..Q0/�.. .. ............ ..4GS ..! ............................................ Tract ........................... ......_.........p......i... /........ DateConnected ............... ....._.. . / . ..._..... ............... -- ................ DateFinal -----------------.--................../...�j.T..-...---.....-----.........--.----._...._._........ 19� . . -------------------- ................ 111 1/60-500 MBING INSPECTOR -