1912 (2) • •_Y �/_9 /JTr�LC �Y i LOT NO. IVV
NO. STREET
Vf'JAN
Q1FOR PLUMBING PERMIT
1 ITY OF CUPERTINO
3 1963 . 1 q
Date , 19" Permit No.
CITY Ct
i`:. 1DERTINO Fee ao
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A'pplicati'on is hereby made to the City of Cupertino for a permit to,,install plumbing
Pi
pes anV% r fixtures listed on the reverse side hereof, and agrees to install said prices
and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
Cupertino, and all other 1 s appplicaabble' thereto.
Use of Ptemise� •m• x
h Owner /J �-' R.�y-/� �p- Address
$y Addres
� CONTRACTOR, AGENT Phonev w=i lF Approved
PLUMBING INSPECTOR
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- Bldg..Dept.
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY 'OF CUPERTINO .
❑ Sewer Connection I Sanitary Permit No. .cMU.qg.....,
.....
Plumbing Final Plumbing Per No.A : 7.........
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Owner or Tenant ..... .. ....... .. ......:.::.:....................: . ..........Ga .............
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Tract ..
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Da fe,Connected .............. (03
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abate Final ........... r19
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PLUMBING',,lNSP`ECTOR
111 7/61-500