51179/D/ -2-,/ ( BIN //� , LOT NO.
NO. STREF.I'
APPLICATION FOR PLUMBING PERMIT
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aY OF CUPERTINO
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3'a Date 19 Permit No 'ei��I7 rI
LL iMAY 21 1968 Fee S 3 ,f71
O Application is hereby made to the City of Cupertino for a permit to install plumbing
0 pipes and/ t re to � ¢¢w�ide hereof, and agrees to install said rices
i and/or fixdlii aottdatuoblle �jisions of the Plumbing Code of the City of
a w Cupertino, and all other laws applicable thereto.
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PLUMBING INSPECTOR
UNITS
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Area Urams I , 7 \1 1 II Main Drain Fee I
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RECORD OF INSPECTION