51132/ �; 6 70 1 " L/C./LQ/ K.�V�W-ti LOT NO.
N TREE
Ac P ICS' SON FOR PLUMBING PERMIT
z i ITY OF CUPERTINO
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)(JUN 13 1966 sanitary No.
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"o 4 CITY Date 196— Permit No
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Fee S i�
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r Application is here y ma
o e to the City of Cupertino for a permit to install plumbing
°o < pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
> r and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
i w Cupertino, and all other laws applicable thereto.
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�. Use of Premises
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r 3 Owner
AC! Address fW1- 7-d 4 . l CSC
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J, By �.:� `�N f Address /yr
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0 TONl'RA OR, AGENT
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rc R State License �2 ; '� �a 75 Approved w �"
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U PLUMBING INSPECTOR /
FEES I
Water Heate
aste
Urinals .,/,F.—, I V �—" II Fixture Fee 1 _15—
rea
Sprinkler valves I 1 11 Water Sys. Fee I / 0'
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RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
\'Iain Drain
Final