51167.1 PlumbingI�� �^J7 /J✓(.. /�f�i LOT NO.
NO. STREET
AP,PL-ICArTIONzFOR PLUMBING PERMIT
A WI OF CUPERTINO
Sanitary No.. /
i
Date 1967 ;q4(--� Permit No 1 //G 7. f
Fee $ - 3
Application\is hereby madel[orhe16q�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 -C!
Owner
.17
By ' V -
CONTRACTOR, AGE
CONTRACTOR,AGE
PhoneS/S-
State License
C
Address
Address
WILLIAM D. EENEVICH
Approved
PLUMBING INSPECTOR /
Y V
ns
ler
nes
UNITS FEES
Boxes
RECORD OF INSPECTION
Underground Rough...
Partial Rough..
Rough. Complete..
Plain Drain
Final...