51187nek 4 c r Dr LOT NO. q
NO. S"EF.'1'
APPLICATION FOR PLUMBING PERMIT
CITY OF CUPERTINO
Sanitary 1\o.
Date en 1 O S7,11"
ee $ C1 0
Application is hereby made to tlleCCpt�o` ulp o f Mlermit to install plumbing
pipes and/or fixtures listed on t riY1tee se 1 e 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 a)fli ab�the rr tp RERTINO
Use of Premises 11 l
Owner
By K
CONTRACTOR,AGENT
State License
AddressX 1 3�pCX���/'
Add
WILLIP-1 D. SZNz:VICH
PLUMBING INSPECTOR
Water Hcate
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rinklcr Valvcs
RECORD OF INSPECTION
Main