919 (2) J—rb, LOT NO.
NO. STREET
P LICApT14,[I FOR PLUMBING PERMIT
® 4.A {ITY OF CUPERTINO
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Datep,S O 4 195_ Permit No.
A�ITY n �;��PERT N Fee a
tdtion_iFheieby made t� thee City of Cupertino for a permit to install plumbing
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
y Cupertino, and all other laws appl' able thereto.
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`+ Use of Premises
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Owner �,� Address
By �oB AMU Plumh��. � Addr
CONTRACTOR, A ,
Phone Ap ove ',/��9
9-j• r PLUMBING INS C OR �/
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Cupertino Sanitary
.� Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO ��']]��
Sewer Connection Sanitary Permit No. .. _ 6......----.
[a' Plumbing Final Plumbing Permit No. .....
. .................
. �? Lot No. -L :.....---....
Owner or Tenant ..... ............ J/��..
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At �....-- -J. ..... ' ......... .....................v
Tract ........--....r..........:.....:.-�:.1' --..-.-.-..,-.-......._-....,��:
DateConnected .................................. ../' .6 ......................................................
DateFinal .................................. /� .........................
.............................................
PLUMBING, INSPIiCI'OR
III 1160-500 d V'