2399 (2) /'�/�(�♦ '+r....K.- .l.'�`7 , LOT NO.
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APPLICATION PLUMBING PERMIT `
z a CITY OF CUPERTINO
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x o Sanitary No..
3 Q. Date ' ' 196— Permit No ,
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' 0 Application is hereby'made to the City of Cupertino for a permit to install plumbing
°o a pipes an`d/oe fixtures listed on the reverse side hereof, and agrees to install said rices i
z'� and/or fixtures in accordance with'the provisions of the Plumbing Code of the City of h
a W Cupertino, and all other laws applicable thereto. ,
� LL Use of Premises00
oa Owner . _;�i5�"i"/).'., I'r. ., /✓i/. Address='•
z BY.. l(.n.i :�.r 1, i/;J* r ^ . Address
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o•f, State License – 7A --A e
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U PLUMBING INSPECTOR
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