51167NO. STREET
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PLUMBING PERMIT
R 30 1968 #1 P sanitary No.
Date r.
19 -� Permit No. &—// 6 7
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ApplicatPortlisrheieliy mad %gTgi1 (9(�f Cupertino for a permit to install plumbing
pipes and/or fixtures listed on the rev!'r"se�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 _ _ _ /t N -S; 2{r e _
Address r�Qv1 e
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PLUMBING INSPECTOR
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I UNITS I FEES II 1UNITSI FEES
xture
Sprinkler Vulvcs I 1 II Water Sys. Fee
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