2629N
LOT NO. �O
NO_^ EET
D I FOR PLUMBING PERMIT i
z a ' �Ij. Y OF CUPERTINO
r o ''MAR 1964 ii)11�11{{ fp111 fFF' Sanitary Nu.
Rj
o a Date — 196— Permit No
3 LL F C PERTiNO Fee $
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> Wlyl ati is here y made to the City of Cupertino for a permit to install plumb g
o pipes and/or 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
a w Cupertino, and all other laws applicable thereto.
W = p
0 o Use of Premises
3
Owner
Address
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Address
CONTRACTOR,
AGENT
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Phone
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State License
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Approve r
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PLUMBING INSPECTOR
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Sprinkler Valves I 1 II Water Sys. tee I / —
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