1988 (2) v
LOT NO.
NO. STREP.T
APPLICATION FOR PLUMBING PERMIT.
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w2 CITY OF CUPERTINO
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2 Sanitary No.
O a Date �� 19611 Permit No
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W `o Fee $
'- Application is hereby made to the City of Cupertino for a permit to install plumbing
o a pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
Z H and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other laws applicable thereto.
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J LL Use of Premises
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o a - Owner r Address 4 a9 c I �G//AJOAkI l/'
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a By ep/>e !� Address
3 F CON rA 11, AGENT
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a o tate License������ Alpproved
.Uq / PLUMBING INSP CTO
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