51172Wa
z�
W z
Eo
0 Qj
3U
W LL
0
0 W
o�
a
>r
zN
a w
w S
� r
a
00
O O
1 N
F 3
0 a
z�
j o 5"1 o
MQ
LOT
NO. STREET' _
fn I FOR PLUMBING PERMIT
I Y I OF CUPERTINO
APR 6 1966 Sanitary No.
Date 4 G 196 b Permit No 7 -
CITY. 0 C�IPERTINQ Fee $
Application s here y ma e to t I City of Cupertino fora 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 J -0 s.', /2 1,
Ownera/ 'o (— L Address S-
J z By f'� ,!/ �'t [.c ///�x3i�C.. Address
O CONTRACTOR, AGENT
3 r -jT
Phone
W z
0 a c:J % �`9 Approved
a o State License
— U�. PLUMBING INSPECTOR
FEES I
rant
V a 1vcs
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final