1659 (2) cZl 2RAC� �236 (�i3
LOT NO.
No. D aHRT R PLUMBING PERMIT
i
CI b CUPERTINO
�..1
IfJUL
2 7 62 � /
Date 7 19",
9 � Permit No.
-CI Ty OF CUPERTINO Fee $
f� Application is hereby made to the City of Cupertino for a permit to install plumbing
pipes and/or fixtures listed on the reverse side hereof, and agrees.to install said prices
1 and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
��ygy Cupertino, and all other laws applicable thereto.
O ns
Use of Premises
Owner / Address_ d • �"'^O
By _ Address
�• CONTRACTOR, AGB E
Approved
$h'one� 7�3 5J77 1 PP
PLUMBING INSPECT A
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Bldg. Dept.
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
[� Sewer Connection Sanitary Permit No. ......p((p
� / G
ak�i51 pbing Final Plumbing Permit No. ...1��jj .J
Lot No.•...�J..�p ...........
Owner or Tenant
.. ....
At
,Tract ...............
...'.......................--------
:.........
Date'Connected ...... . ................ . ..........:...... ...........................
.. ............ 19` ......
Date Final
..... ........... ........ ......... 19............
..........
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Y
AI LUMBING INSPECTOR '
4rl 1 7/61-500`- '