1032 (2) r l,e. .....C=�"�✓VIA ^-^' LOT NO. #40 a
NO. MEET
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t� . . I ' FOR' APPLIANCE PERMIT
�1CITY OF CUPERTINO
VNOV 8 1562
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Date ��d� 196..... Permit No.
CITY OF CQPERTINO Fee sq.
Applicatiow is hereby made to the City of Cupertino for a permit tonstall
' as a liances as listed on the reverse e e erse side hereof, and agrees to install '
8 pP stal said
B
I appliances in accordance with the provisions of the Plumbing bode of the City
,of Cupertino, and all other laws applicable the eto. 4
Use of Premises
Owner
SAN CARLOS HEE ;•• y ,, y,1159V--OL
COIw o ). ?dAdd_e"ss'
SAN CARL S,qCK �Q811rGBNT '£`
Phone ` ✓ a yilppidved
PLUMBING INSPECT
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