2401 (2) �S61iu i V Q</ ✓e , LOT NO.
�QJ�
r/ LICAT, ONJIFOR P4UMBING PERMIT
W 2
m d 5 '� t5JCITY-OP CUPERTINO
' 0 Sanitary No
0
° a Dater ' �19�r3 Permit No
3 Pee $ ��
= o
Application is hereby made to the City of Cupertino for a permit to install plumbing
o a pipes
and fixtures listed on the reverse side hereof, and agrees to install said prices
' r H and in fixtures in accordance with the provisions of the'Plumbing Code of the City of
V)
Cupertino, and all other laws applicable thereto.
WI /
J LL Use of Premises _
00
Owner V; 'Vef" 6z Address
0 3
o a 120-
J z gy a L a �lG f r Address /
°
P Cq RACTORR A n
3
— 0 Phone.�XT
u f State LicensAPP rovedC
0
"'��Cfn✓ �,, f PLUMBING,INSPECTOR,.• .
� 4wg3 � w { §% cz ® = = comm / § gf2rr � E ,«
{ \\ ) & ( \} .
�
�
2
» @ , q / f � � mq 22 / z = 000
c , . r . �
/ & E r)
•Bldg. Dept
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
Z
\ `I
� Sewer Connection Sanitary PermitNo. .G......._r..../..............
�umbing Final Plumbing Permit No. .>��.. ���.........
1 .
Owner or Tenant . '�•(�\( SS+-(� h f .............
•� ....t `.. T
Tract ..................................................
:J
(`
Date Connected ...................................... .... . T '...L� �.. ..:....:.:.......:......._-^ 1 �......
. .
Date Final ................................................. r......... ........
.......- 19............
PLUMBING SP CTORQ:
-Ilt 7/63-1M