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PLUMBING PERMIT • �: .
CITY UPERTINO
EP 26 1961
Date 195_; _ Permit No.
CITY OF CUPERTINOFee $� )
N Application is hereby made to the City of Cupertino for a permit to install plumbing i
pipes and/or fixtures listed on the reverse side hereof, and agrees to install said,prices
�1 and/or fixtures in accordance with the provisions of the Plumbing Code of the, City of
Cupertino, and all other laws applicable thereto.. f,
o
B Use of Premises
Ownere��+,..r_ 9—'J e,,6ZZAa,Address
By, Address
CONTRACTOR, AGENT -
j re`
1plle I .moi? �- P/// _ APPioved
` `� PLUMBING INSPE OR
N
0mr3a''ll ,_MAIN,DRAIN
rs FEES II IUNITSI.FEES
Size ia- ,,;,.I
•� Material H S
To Curb
- To. Prop. Line .I.�
To ,Existing
N Con
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. S: RM DRAINAGE
Sizei
I' II' Mat_e,lal I' .
I II ,To m Drain I Sr I
II
To,) •i. -I .
II . 'sem _
Sprinkler Valves I WM Sj' vFff,.I /,00
RECORD OF SNS2ZCltjION -
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• . - - - - Cupertino Sanitary
... . Office Copy
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BUILDING
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INSPECTOR'S 'OFFICE ., }
. • • . CITY
Or CUPERTINO
.,,,.� Sewer Connection'-
� -� 'Sanitary �Pemut No.•�-.0?.. '
` Plumbin Final
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.Plumbing Permit No../. -.------...------c.'•
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TMBINC INSPECTOR
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