51167LOT NO.
NO. STREE.I'
APPLON FOR PLUMBING PERMIT
® � Ci OP CUPF.RTINO
Sanitary No.
Dare Y `)'7 In Permit No � �,-6 /
N f 7- Pee $ O
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ApplicCI Ys �%%eby de to the City of Cupertino fora permit to install plumbing
pipes and/or fixtu Elis I erse side hereof, and agrees to install said prices
and/or fixtures in accordan klthl�j ,(�}ovisions of the Plumbing Code of the City of
Cupertino, and all other lases applica e thereto.
Use of Premises Dwelling
OwnerDitz-Crane Co. Address P• 0. Box 509-san Jose
o By Palm plIm ing Co
3 r CONTRACTOR, AGENT
— m Phone 2115-2323
w z
W W
�a
a o State License �18�9
_ u/I
Address 1234 N Hi -q 9 -Sunnyvale
Approved Q /
PLUMBING INSPECTOR
Water Heart
rinkler V.
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Alain Drain
Final