NOV 1967//v & .L
NO.
N Q
wz
LOT
STREET
APPLICATION FOR PLUMBING PERMIT
qC Y OF CUPERTINO
Sanitary No.
Date ✓ ' 96_ Permit No
Pee S ' 3,
Application is herebmade to the City of Cupertino for a permit to install plumbing
pipes(38Thfr fli�luresC��,KpTt�@aerse side hereof, and agrees to install said prices
and/3r fixtures in accordance wi h the provisions of the Plumbing Code of the City of
Cupertino, and all other laws applicable thereto.
Use of Premises YL_LA2C.eG-c.P
Owner ! ff / I—! I"' SO[-OMO Address 1/06+2—
Address 2'
WILLIAM D. BENEVICH
Approved
PLUMBING INSPECTOR
FEES
Heater
ns
ps
Main Drain Fee
Sprinkler Voives I 1 II Water Sys. Fee
RECORD OF INSPECTION
Underground Rough...
.Partial Rough..
.Rough. Complete -
Alain Drain
Final...