2025 (2) aO G 9 / „"• t LOT NO, /
APPLICATION FOR PLUMBING PERMIT
w Z I APR 18 1963 r�Y OF CUPERTINO
, 0 Sanitary No.
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3 a Datcl - i /! II T'nt'196� Permit No
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0 Application is hereby made to the City of Cupertino for a permit to install plumbing
o pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
i and/or fixtures in accordance with the provisions of the Plumbing Cnde of the City of
a w Cupertino, and all other lus-s app
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j LL Use of Premises
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3 Owner . "��/ Address
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3 0 CO ACTOR, AGENT
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O Y State License /�/ 5 S D S Approved
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