1220 (2) SLOT NO
NOO.. 'f'1 STREET • /K.
�® V ON FOR PLUMBING PERMIT
'3 I SEP 13 1961 CITY OF CUPERTINO
Date 195_ Permit No.
CITY OF CUPERTINO Fee $ 7
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 Ci f
Cupertino, and all other laws applica le thereto. S-D-N
Use of Premises � t>J 3�'�—D U��
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y Owner , , .R�. ./�l'1.+.J�JlZG4'r�.i Address
V" Address
� � CON�' OR, AGENT. �
G� 'I hone )rza+ .�y � J /3S6 _ Approved
PLUMBING INSPECTOR
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