51187 (2)7-) I //Jil . LOT
NO. STRE F.T
PLUMBING PERMIT
'DEC 16 1968 �t� sanitary No.
Date 6� 19 --' Permit No
L,!Tt• l'I h n Fee $
pF- T
Application is hereby. mad �tb ithe City.�sf 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 A:�-E,5/-1D S LI 6
Owneerr/'
By
CONTRACTOR, AGENT
Phone �;76
State License��
Address2/—Z7-S
Address'7q-eo, y�y0
Approved WILLIAM D.
PLUMBING INSPECTOR
FEES I
mm
Sewer
xture Fee
RECORD OF INSPECTION
Underground Rough...
Partial Rough..
Rough. Complete..
\lain Drain
Final...