875 (2) LOT NO. .
li No. STREEa
APPLICAVON FOR PLUMBING PERMIT
CITY OF CUPERTINO
r�4lG 9 1960
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Date _ L 5 Permit No.
9
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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
it and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
Cupertino, and all other laws applicable thereto.
u Use of Premises
Owner Address
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gy1Ut Ki.i^.P.'. GIiJG, I C• Address
caiAxnciofv;lAcerrr�
Phone SANTA CLARA, CALIFORNIA Approved
PLUMBING INSPECTOR '
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Plumbing Final «? Plumbing Permit No. ------------------------------
Lot
,..,..:r....................Lot No. ------------
Owner
Owner or Ten li[C.�'
Ci-YiG: ....
_. ...._.._ �C%' .t %ems trY'............ ---------- ------
Tract ......... ... /i Ght C ................................/1
Date Connected ..... ........_...._C/'.?'� �:'194
DateFinal ..---.....---- ----...-- f' ........_.... .. .. ------------ 19AW
III 1/60-500
�iPLUMBING INSPECTOR
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