51179LOT NO. S9
NO. STREET
APPLICATION FOR PLUMBING PERMIT
CITY OF CUPERTINO
Sanitary No.
Date"�'4,1 Permit No
A '�/
IJUL 2 1968 Fees
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 f� ini��Corlti�{r�l visions of the Plumbing Code of the City of
Gmertnn al Yhrr 1��/ c1'�R 1��F� rh rntn
of
Phoneya��3 91Y/
State LicenseoR-3/V57oa'/
Approved
PLUMBING INSPECTOR
ns
Sprinkler Valves I I II Water Sys. Fee
RECORD OF INSPECTION
Underground Rough...
Partial Rough..
Rough. Complete..
li Final...