51118Jd t( 57-5� 1,7 IJ 1'-i LOT Nn.
NO. STREET
CITY OF CUPEErKr) CITY OF CUPERTINO
"a
zOCTA&Afbf�1CATION FOR 'PLUMBING PERMIT
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x O r sanitary No.
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a Date 1971 Permit No
w LL Fee $
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� Application is hereby made to the Cit}' of Cupertino for a permit to install plumbing
`o a pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
> r and/or fiStl,rCS in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other Taws applicable thereto.
a Use of Premises
J 0
r 3 Owner �i_� S!/ z"1 �'✓LS Address
oa
z �7 _
� z By -`G Address
Jo
CON 'RACTOR, AGENT
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— Phone �2
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u s $tate License Approved�ILL!: .:!1 D. ._
ao /
PLUMBING INSPECTOR ^/
Dish Washer
Water Softener I I II Material I I
To Curb
WATER
Sive
Water Svs. Fee
Total I SG Ka'� 11 Total Fee 1 9 J>'_
Aa�Q�MWY
LOT
FOR PLUMBING PERMIT
OF CUPERTINO
26 19620
Sanitary No.
Permit No. S—///.47,
Pees '.3•'-0
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 appl ble thereto.
H
o. u \
Use of Premises �4- V. R L `'�
Owner_-�/f h.
;, By,4 0 A P/K . R -Z 4 5 A-
O CONTRACTO ,AGENT
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— Phone.1 u 7
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¢ a
a o 1 State
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License "iT79Jp
Address_/nNI'S—�/',v11. —
Address 3516 14,e j4. h n.
28-7b��
Approved
PLUMBING INSPECTOR
MAIN
Water Heater
Comb.Sink & Tray To Curb
Dental Unit
Drinkine Fountain
Size
Water Svs. Fee
rerm�r ree - I
Total Total Fee z i J