1953 (2) LOT NO.
NO. STREET
t?) ,NPP,LICATT 6if jFOR PLUMBING PERMIT
9� W 41
CI IOP CUPERTINO
l rFEB 2 5 1963 9�.3
Date 4;PAVP,1//Y Z. 1,47 Permit No.
CITY Or CUPERTINO Fee $
a Application is hereby made to the City of Cupertino for a permit to install plumbing
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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
Cupertino, and all other laws applicable thereto.
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Use of Premises //�S/12L--Al4 t-
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n Owner INLAND fMPlRa Obv, !A C . Address_ GA/N�BdGL
By ",//O y A1//1J q/M1Address
CONTRACTOR,
AGENT
Phone �7k-�/// Approved
PLUMBING INSPECTOR
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