51192 (2)NO. TAEET
*PPL'ICATII
(MAR 2 1968
LOT NO.
PLUMBING PERMIT
CUPEiRTINO
p Sanitary No.
Date `� 196–F Permit No. '5
('ITV �� i���TIrIA Fee$oZ a—Cf�
.1 L -t f(ll r... •1
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. -
Use of Premises _CS
Owner_ 'r-&4 _C7_1a0W'6S A dress 40 aoz--
By
pCONTRACTOR, AGENT
PhoneAq a' D,rSG
State License /71537
U
-- •I
Add resfi25 Charles Street
San Jose, California 95112
WILLIAM D. SENEVIC'-4
PLUMBING INSPECTOR, >/
FIXTURES I NUI7BER �� MAIN DRAIN
UNITS FEES UN'.
Material
Shower
of Conn.
Dish Washer
Waste Dispo
Comb.Sink & Tray I 1 11 To Curr
DrinkiMFountain ��
Floor Drain WATER SYSTEM
Hopper Size III, IIS°
Valve
TOTAL F
Fee
ee