2592I APPLICATI N FOR PLUMBING PERMIT
ZFEB 28 1964 QIL`T,Y)'OF CUPERTINO
'X Sanitary No.
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3 a Daten.'�/ fi '/411gCD'•'`' 196 `� Permit No,
Fee $
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Application is hereby made to the City of Cupertino for a permit to install plumbing
o a pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
r i -and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
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Cupertino, and all other laws applicable thereto.
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0 o Use of Premises ^-'—�-�����
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0 3 Ownz'-Ak -c'% Address
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z By o< (� Address
CONTRACTOR, AGENT
3 0 Phone.��
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E State License ��• Approved
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J-L PLUMBING INSPECTOR
FEES
01
1'
3
JDlsh Washers M I /✓-� II Sewer Boxes I �.3✓U
Area Drains I 1 11 Main Drain Fee I ' o -v
\1alves
RECORD OF
Alain Drain