51189 - BLDG #58c No. Street
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o DEC 22 1971
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APPLICATION FOR PLUMBING PERMIT
CITY OF CUPERTINO
1 p,. Sanitary No.
p Dat `�Q' %2� , 19yL Permit No.
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Fee S44,To
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 �
Owner
By �. . i AgGb s Uc
Co rap , ent
y
Phone � ) '%4�- 0-2/
State License
Address Z17/ 4ex". 'ez11
2980 Winchester Boulevard
Com ell, California 95008
Approved
•C Plumbing Inspector VZ
Dish Washer
Machine
Floor Drain
To Curb
Permit Fe
Total Fee