5119710-47,1 v C F/ _ LOT NO. -
NO. O.NO. EF.T
APPL5IGATIQN FOR PLUMBING PERMIT
a CITY VL� CUPERTINO�
z-
1
o �JU ti4 19E8
Q LL
O J
3a
w U
0
4 w
o�
a
>r
za
a w
w 2
� r
a
J
O0
_ O
7 N
r3
oa
z J
Date (� ! a, 1966 Permit No. op
t;l1PERTINO Cee$
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 _-f_
License
Addrespr�%4�.1�7i �
nes
ns
rmkler Valves
.Sewer
UNITSI FEES I
rermlt tee o(. o 0
TOTAL TOTAL FEE 4647.0 O
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final