2630N
LOT NO.
.No. 0 TR O ---
?MAR
1 � IR PLUMBING PERMIT 10OP CUPERTINO
I 4 1964 Sanitary No.
Date - 7 - 196!% Permit No
Q
CITY OF CUPERTMO Pee $ /
Application is hereby made to the City of Cupertino for a,permit to �pplumbing
pipes and/or fixtures listed on the reverse side here f, and agrees to install said prices
and/or fixtures in accordance with the provisions ofllthe Plumbing Code of the City of
Cupertino, and all other laws applicable thereto.
Use of Premises
v
sy ,�C.l`.
CONTRACTOR, AGENT
Phoneme '� 3�
State License ee6 S5 Z_
Address
Approv
PLUMBING INSPECTOR
Heate
aste
Valves
'Iain
OF