51167.1� LOT NO.
G G
NO. STREET
APPLICATION FOR PLUMBING PERMIT
N
W i �\ ITY OF CUPF.RTINO
o `s c� -. (� S:mitary No.
O /
3' Date AUG 11 1957jO� Permit Nn_-s�/i (o 7.i
iLL Fee Sa3-5O
O Application is hereby made to the City of Cupertino for a Permit to install Plumbing
o a pipes al� yViixtures Ii tedmm�thelres�erse side hereof, and agrees to install said prices
> r
and/Or fixtu s mliiccord�n eLwith tkte�kovisions of the Plumbing Code of the City of
U)
Cupertino, and all other laws applicable thereto..
~ ~ Use of Premises
0 3 Own�yAddress
By Address
3 CONTRACTOR, AGENT
Phone
wz ry
a o State License �aG /�y Approved
U PLUMBING INSPECTOR
UNITS I FEES
nes
Boxes
Sprinkler Volvos I I II Water Sys. Fee I t ro
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final .