2598COT NO. L
NO. /►P SIEAtI14
"IFOR�•PLUMBING PERMIT
_ CI Otr CUPERTINO
FEB 2 8 1964 Sanitary No. _.
H
Date �` O — 196 Permit No
0
CITY QF CUPERT; !" Pee s `—
Application is ereby 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
flaws applicable thereto.
Use of Premises
OwnerAddress)/o^--a-�C-c.<�
By �` �' � �' - Address
CONTRACTOR, AGENT
Phone.
State License o "' Approved
i5UYNi RG'IIi$PECCOR
FLUS
0 Water Heater
Dish Washers 71 1 II Sewer Boxes 1 13-"
a
Sprink],r Valves I 1 11 Water Sys. Fee I / I —
RECORD OF
Main Drain - 4-- /— 4e,4 ate"