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52301 (2) No. sTRFP.T' CITY OF CUPERTINO /S 0 do Lw of PLICATION FOR PLUMBING PERMIT s� r o MAR 21 1972 Sanitary No. a 1):Itr 19 — Permit No f 1-2-3 U• UT i o A Pec $�L S 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 'zand/or fixtures in accordance with the provisions of the Plumbing Code of the City of a w Cupertino, and all other laws applicable thereto. a 0 w Use of Premises 00 > w , 3 Owner-L��//l/� �/�rr�/l�/O fMddress o a z J � z riy_ /fyi'/SF-�✓pCIJS Address �F'>.G�fC�U CONTRACTOR, AGENT 3 < Phone_;75 w z w w � a a o /State License ;91�—��t ,5r9 Approved - U PLUMBING INSPECTOR Ir ® # ! ! ; [ me $ & & ! & ; 0 ƒ , » » d / ƒ Er / I000 ; �` © ` ~ I » E � ' o ! ! ' ` r ! ( E ° * ! 2 E \\ \ \ \ \