738 (2) SLOT NO.
STREET
n�A�P4 N FOR PLUMBING PERMIT
® 6 �a OF CUPERTINO
tMAY 161 3 �'
D Permit No.-
C�ITY OF CUPS TINO Fee 1,,'71 °a
ppl1ration is hereby made to the City of Cupertino for a permit to install plumbing '
1 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 /
'4
v
� n r � � L/✓� ��¢Lddress
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By I LPJumhing, Ina• ' Address
co
AGENT •-�'.
Phone ��G—�y63 Approved
PLUMBING INSPECTOR
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w
ino Sanitary
71 CupertOf
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
❑ Sewer Connection Sanitary Permit No.
R/Plumbing Final Plumbing Permit No. .....!'-7.,.%3',9.........
W.-
Lot No. .....
Tenant . .....
Owner or Ter --!,
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4 . . .
At -........../
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........ ..
Tract ....................
Date Connected .................. ........ .......... ---- 19-Go
Date Final ..................................
. ... ......... .. ................ 19
.. .......... ---- ------
Pi.UMBING INSPECTOR
1 17 7/59-500