51179/y Z '97 ae'e LOT NO. yA
Na AP5�1� NMR PLUMBING PERMIT
z a CITY OF r t PERTINO
i
ro sanitary No.
3 a Date �� 196$ Permit No 7
LLCITY OF CUPERTINO Fee $ -3..
o 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
> and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other laws applicable thereto.
w
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0 w Use of Premises
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Address CG D �u`
Address- 2-01-
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Approved'-l:`L.:..: D' "ENEViCH
PLUMBING INSPECTOR
ES
ren
kler
RECORD OF INSPECTION
Underground Rough...
Partial Rough..
Rough Complete..
Main Drain
Final---