1764(01 I QAC
APL CA
f AUG ? D 1962
_ l
I' FOR PLUMBING PERMIT
Y OF CUPERTINO
Da 61 if 0� CUPERT M1
Application is hereby made to the
n pipes and/or fixtures listed on the
and/or fixtures in accordance with
Cupertino, and all other laws appl'
8 Use of Premises „eZ4 L
a
Owner
By. k ONTRACTOR,AGENT
195_ Permit No. /76,-/—
00
Fee $
City of Cupertino for a permit to install plumbing
reverse side hereof, and agrees to install said prices
the provisions of the Plumbing_Code of the City of
cable thereto. i _
S
Address�CLI�Ccs.-•L
Address•S"
- G
Approved
•"` PLUMBING INSPECTOR
anowers
p .�F.
�., ..
Lavatories
To Existing„
i;l
,_-Kitchen Sinks
Not Corin.
+;I:;
I?sh Washers
SEWER BOXES
•,x�'s:.
' Waste Disposals
Wash Trays
II STORM DRAINAGE'
S r,Lkler'Vawest\ I i it water ays. rcc I.
RECORD OFINSPECTION
Partial Rough
Rough Complete
Final