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LICATION FOR PLUMBING PERMIT
O CITY OF CUPERTINO
V1000(`. \��Sanitary No._xJ G' ,19¢b Permit No..i J—//&F .�
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3 y fin' .. Application'is hereby made to the City of Cupertino for a permit to install plumbing pipes
Snd/or fixtures listed on the reverse side hereof, and agrees to install said prices and/or fixtures j
o in accordance with the provisions of the Plumbing Code of the City of Cupertino, and all other
. .2 laws applicable theretv-
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—Contractor,Agent
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Phone 52
State License
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Address o2/.3iC AN ale, f
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Address
. WILLIAPA D. DENEVICF.
Plumbing Inspector
NUMBER
Dental
To Curb
t Fee
Fee