NO PERMIT NUMBERNO. STREET
APPLICATION FOR
5 (' CTy F
Date����? 14F7 I96�
LOT NO. 9 4/1
PLUMBING PERMIT
CUPERTINO
Sanitary No.
Permit N
Fee $ .�iS-• 0 oe7 >
sarues at[h�tseuhno rag'toinstall
alumbing
pipend%o6xtstedo`nhe�eerside ereof, andareestoinstallsid prices
and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
Cupertino, and all other laws applicable thereto.
Use of Premises
/W/i ��
CONTRAC170R,
State License r>?2ef 23%J
Address
wtusan� o. e>=N�'vlcH
Approved
PLUMBING INSPEC[OA
v
Water Heate
nes
nller Vo
ain Drain
RECORD OF INSPECTION
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