NO PERMIT NUMBER (3)LOT
NO. STREET
APPLICATION FOR PLUMBING
CITY OF CUPERTINO
Sanitary Nc.
Date Sept. 18 , 1968 Permit
PERMIT
Fee $ J
Application is hereby made to the City 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 HOUSEHOLD
Owner F. F rA.ZZ Di.A Address 2137.5 DEXTER DR.
By_ ""TW
INC_ Address P.o. Box 696
CONTRAC�fOR, AGENT
Phone 379-5050
State License 234281 a Approved
PLUMBING INSPECTOR
Water Heate
rai
nklrr Valves
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final .