51167.1LOT NO, t
,;'APPLICATION FOR PLUMBING PERMIT
'1:,�� rl ITY OF CUPERTINO
Sanitary No. S3 i b
Date/' `-r 1957- -"- 196 7 Permit No.
yy Fee $
Application is hereby,?inadeltolj the City of Cupertino fora 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
By,��iz/
CONTRACTOR, AGENT
Phone =?Sly % =?-3 -2 3
State License
—U�
Address
Address
ApprovedWILLIAM D. E=NEVICH
PLUMBING INSPECTOR V
I UNITS I FEES II IUNITSI FEES
Wares Hcate
ns
ler Valves
RECORD OF INSPECTION
Underground Rough...
Partial Rough..
Rough Complete..
Main Drain
Final...