1835 (2) • / V 'I 4 LOT NO. �•
APPLICATIO qPR PLUMBING PERMIT
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O 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
iH and/or fixtures in accordance with (he provisions of the Plumbing Code of the City of
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a w Cupertino, and all of aws applicable thereto.
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Bldg. Dept.
Office Copy
BUILDING INSPECTOR'S OFFICE
I' CITY OF CUPERTINO
0 Sewer.Connection Sanitary Permit No. ..... bL
�umbing Final Plumbing Permit No. —14?S4
Lo[ No. ----.._-........ ..... .
Owner or Tenant ....... .... .. .... ----- _
--- ..... .. _.
At
Tract ......
Date Connected -.....//(/ ✓ 19..iP�
Date Final _. % 19..f�.
000
PLUMBING INSPECTOR
111 7/61-500