51226No. Strut V
Cry OF cUPERTW0 /l
APPLICATION FOR PLUMBING PERMIT
JUL 21 1971 CITY OF CUPERTINO
Sanitary No
pDa e Iii�/f7
Lot No.
Permit No. S/d-L6
Fee S D3.5-0
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 P}umbing Code of the City of Cupertino, and all other
laws applicable thereto. 04r-)
Use of Premis
Owner �/
By
CPPntra
Phone �T�
Address
Approved P/
--�"Pln ibing Inspector
Units
To Curb
Size
Water Sys. Fee
Total Fee