51179/aa 7ffPOIT
LOT NO.
bfflCUPERTIN0
PLUMBING PERMIT
NO.Y
Y o �'� ] MAY 31 1968 sanitary No.
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0 < Date— �_, 196Z Permit No]�Lr—
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W W Pee $ .'3
CITY. QE CIJPER
=o TINO
Application is hereby made to the City of Cupertino for a permit to install plumbing
o`Por fixtures listed on the reverse side hereof/es anand agrees rees to install said rices
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 2
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LL Use of Premises dirt
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30 %die, Fg/l
0 3 Owner
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Z By �d([py -Se �f Gf/aTD�
O CONTRACTOR, AGENT
—0 Phone
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a o State License eo
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Address —S,r
Address Y�� C�C'SC ec
Approved
PLUMBING INSPECTOR
Boxes
aste
ater
Fee
ns
,rinkler Valvcs
RECORD OY INSPECTION
Underground Rough...
Partial Rough..
Rough. Complete..
\Iain rain
D
Final...