NO PERMIT NUMBER (4)NO. STREET
® RP C T O N
v
C
Y:- 1 ��
LOT NO.
FOR PLUMBING PERM
OF CUPERTINO
Sanitary No.
Dat
e
-V - � 1964 Permit No
CITY / �� r �[p� pee $ �j
Application is Yie6yiiVPJQ the City of Cupertino for a permit to install Plumbing
pipes and/or fixtures listed on �Ehe reverse side hereof, and agrees to install said prices
and/or fixtures in accordance with the provisions of the Plumbing Code of he City of
Cupertino, and all other laws applicable thereto. .-)v?7,-_ y[t,LQt.y,�yy 11V -
State License
'173oL
Approved
PLUMBING INSPECTOR
UNITS I FEES
A "
.6-0
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final