1150 (2) LOT NO. �Q
NO. STREET o
AP A R PLUMBING PERMIT
® CUPERTINO
1 Date - JUN 16 '�+V' _ Permit No. /
(� jy nF ll�ERN - Fee'$. lq -
�• Applic3El�d e� hPf�by a8e,to the Cityoof Cupertino for a permit to install plumbing
j \ 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
i Cupertino, and all other laws applicable thereto.
Use of Premises
Owner OIVtN' d'ILT N B.4&4& Address Al fd,fN
By PU90 Y ,oL//i7iA/Nd Address LR
�. CONTRACTOR, AGENT
IY Phone_ 4W F- 9/// _ Approve
PLUMBING INSPECT'R Ld
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BUILDING INSPECTOR'S.. OFFICE
.CITY OP CUPLRTINO s
�- Sewer Connection SanitaryPermiE No. .... !J..RTT.. ........... `
�-.Plumbing Final Plumbing Permit No. .ZZ— - -
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Owner or Tenant..- 7 .. .
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