51175COT NO.
NO. STREET
n 1 A N FOR PLUMBING PERMIT
�< D
TY OF CUPERTINO
x o f OCT 26 1967 Sanitary No.
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Date 196— Permit No 7 S
CJ IF is gUPERTINO Fees 3s _tom
plica on ereby 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 rices
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
State
4j
AGENT
ApprovedlLL1AM D. SENEVICH
PLUMBING �ISPECTOA !/
Water
ns
FEES
00
J-0
Sprinkler Valves I 1 II Water Sys. Fee I / Sw
RECORD OF INSPECTION
Underground Rough...
Partial Rough -
Rough Complete..
Main Drain
Final...