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V a�1ICA
NOV n g 1910
TION FOR PLUMBING PERMIT
CITY OF CUPERTINO
Sanitary No.
Lot No. 2 �
`A-- D V, IT.5
Date 1 t , 197Q Permit No. 5- 112
CITY OF CU ERTINO Fee L)4So
Application is hereby made to the City of Cupertino for a permit to install plumbing 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 Cupertino, and all other
laws applicable thereto.
A Use of Premises A'PT6.
Owner AV E2:/ C -o &LST in . Address
By SAID JoSF- 1,je-
Contractor, Agent
Phone '2'l�-4104a
State License
Address Ibbs 'pNG�EftS kJr, S.J
1Approve1-19-70d
lumbing Inspector
Dish Washer
Water Softener
Comb.Sink & Trav I I II To Curb I I
Floor Drain WATER SYSTEM
Hooper Size I ,. I
Water
Total