51167.2 (2)3
No.
Lot No. y4'
APPLICATION FOR PLUMBING PERMIT
CITY OF CUPERTINO �
Sanitary No. 6103 5
Date _, 196 P'� -Permit No..S��li % 2
FeeS23,-S
Application is hereby made to the City oflCupertino Lfaij�(permit jo install plumbing pipes
in accordance with the provisions of the Plumbing Code of the City of Cupertino, and all other
laws applicable thereto. .v , _ • --rY•' " -
Use of Premises Dwelling
Ditz
Owner
By Palm Plwabing Company
Contractor, Agent
Phone 245-2323
1156579
State License
x
De La Cruz Boulevard
� SSunrwvale-Saratoga Rd.
,
Approved
r Plumbing Inspector
Dish Washer
Washine Machine I I 1 II size I I
To
Floor Drain I 1 II WATER SYSTEM
t Fee
Fee