2029 (2) " ✓ / LOT NO.-
NO.
O.NO. STREET
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APPLICATION FOR PLUMBING PERMIT
1
APR OG 9 CITY OF CUPERTINO
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Date-• y' .:��i -- ••'+°'�•1942� Permit No.60h
Fee /5 ' On
Application is hereby made to the 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
Cupertino, and all other laws applicable thereto.
Use of Premises
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Owner S S �� Address
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CONTRACTOR, AGENT
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PLUMBING INSPECT00.
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Office Copy
BUILDING INSPE&6R,'-S OFFICE
CIOF. CUPERT
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2' Sewer Connection 4an4 Permit No.
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0 Plumbing Final Plumbing Permit No. 5�?�Cj...... .
No I
Owner or Tenant ........
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At ...........ts.1......
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Tract
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Date Connected ..................................
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DateFinal ...................................
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III 7/61-500 PLUMBING INSP 0