5118221434 I SHANNON CT. or No.
NO. SnEE'I'
PdP ASI PLUMBING PERMIT
a i� taF"I31' I,� UPERTINO
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I Sanitar No.r ° MAY 31 1968 }
o Uate May 6, 19 - Permit No, 16—Ilb'.1.
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LL CITY Q� //��ff n[[pp f� I//�� Pee $
O Application is hereby ❑4dURT RI4i & Cupertino for a permit to install plumbing
`o 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
a Cupertino, and all other laws applicable thereto.
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Use of Premises HOUSEHOLD
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3 Owner w. FONG Address 21434 SHANNON CT.
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o By 90 MASTER, INe. Address P.O. Box 696
3 o CONTRACTOR, AGENT
— w Phone 379-3050
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ao State License 234281 Approved
- IUy1, PLUMBING INSPECTOR
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Valves
Final
UNITS I FEES
Sewer Boxes
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