124 (2) e rz Fz t r i � LOT NO. /
NO. STREET .
D A01
R PLUMBING PERMIV
CI CUPERTINO
MAY 261961Date J5 � Permit No.
CITY OF CUPERTINO Fee $
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.
8 Use of Premises—Z
Owner Q Address
Bye ZA Address Cr/�
CONTRACTOR, AGENT (/
1Phone['/ ^ 3 4- _ Approv`
PLUMBING INSPECTO
• npy 9 < � dw � �� dao � _v, � ope HC7I � ° rv�� Win ? H
a �C
e ° 3 0
_ n
n ?' ry � ❑ a � S w cn
---------------------_ —C
t*1
---------------------------
R.
7 y 7
In
O y N w N > o o w N 0 0 0 y N
� R r M G d
Cupertino Sanitary
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
❑ Sewer Connection Sanitary Permit No ----
B"Plumbing Final Plumbing Permit No.
..1;2
. .............
Lot No. .....-;.7-------------
Owner or
---- -------
Owneror Tenant ----
--------------------------------------------
At ....
.... ............ ...--------------------
Tract
-- --------------------Tract .......... ...4�
�- - - --- - ---------4-: --- -------
- -- - - ------
---- --- .... ..
DateConnected ----------------------- ------- -.07......... ... . ... .. ......... .. ........... 19.41-
DateFinal ----------------------------------- . .0.....----......----------..--------------------- 191W
UMBING INSPECTOR
tit 1/0-5o0