51189 (13) LOT NO. bAye' PS Z4,'AV/7 '
No. STREET BGOG f- S
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ATION FOR PLUMBING PERMIT
z d I t' OF CUPERTINO
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Sanitary No.
o ' Date b , 96— Permit No
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LL ()��- / Pee $
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Aj)plic.tw r h �2�iy� to the City of Cupertino for a Permit to install plumbing
o pipes and/or fixtures PSte�wii liipreverse side hereof, and agrees to install said prices
and/,dr fixtures in accordance with he provisions of the Plumbing Code of tate City of
a w Cupertino, and all other laws applicable thereto.
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Use of Premises
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Owner
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py�c�9WLB/ CO Address ) �/
3 O CONTRACTOR, AGENT
- o Phonc-967 5 157JI
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f �G�99� A )rovedPPILIUMBING
a 0 (t State License Pf
—U �}— �' INSPECTOR
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