1855 (2) NO.
NO. STREEY
ARP ACATION FOR PLUMBING PERMIT
� a o
I Y OF CUPLRTINO
wrc
r oSanitary �\u,
rc _
° J Date92 Permit No, � ��-
3u
wLL
Fee $
' 0 Appht" isffebflii PT of Cupertino for a permit to install plumbing
'o a pipes a d r fix res Ii§ c6l o t e reverse side hereof, and agrees to install said prices
iand/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a m Cupertino, and all o laws appy lblc thereto.
w x
r �
LL Use of Premises
o_ o
> N
a a Owner Address
z
o BY Address '
3
' — m PhoneT
w z /
¢ a '
a State License ApproVed
V
CONTRACTOR, AC EN
- « I , � \ } /\ � // } \ ¢ ( � / & $ ■ / [}!
$% �
- U \ rr ,
4: St. 4L" @ ) > so / @r 2r@
ƒ � )
2 « 29 ( ( 2cr) k \rm
� _
tl
/ 9
, � o
' Bldg. Dept.
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
❑ Sewer Connection Sanitary Permit No. ... .4-rP�
.. -------------
[40'IPlumbing Final Plumbing Permit No. ../ �
------
LotNo. _. ---....----....__.
Owner or Tenant -----
At
----
Tract .........._.....
Date Connected ._.... -- ...._.....lo(. l/............ ... ........... ....... ---------.. 19L.
DateFinal _--.. ................ ��0 .. _.......-..-----....-------._ 19
PLUMBING INSPECTOR
111 7/61-500