51167I cor.>'gxwrcn _ LOT NO.
NO. SnEET�
0PI! PLUMBING PERMIT
0 1.1 PERTINO
30 1968
Dat
.-I Sanitary NU.
196d Permit No. 5-i/6 %
Fee s 3.50
Appli cation. Is hcr8lima�d��ti' Fh�siYy�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 fixtures in accordance with the provisions of the Plumbing Code of the City of
Cupertino, and all other laws applicable thereto.
Use of Premises
Owner T) 11I1GGI FAT
By SOFPMASTER, Inc.
CONTRACTOR, AGENT
Phone 379-5050
Mate License 2442R1
Address 21735 Cn1LTNf4V0RTA
Address P.O.Box 696
PLUMBING INSPECTOR
ns
klcr Valves
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final