51167LOT NO.
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APPLICATION FOR PLUMBING PERMIT
si f �' TY OP CUPERTINO
z
r o Sanitary No.
o a DateV-19� Permit No
3� JUN 13 `�
Pee $ e—d
�0
Application is hereby made to the City of Cupertino for a permit to install Plumbing
o Pipes toj�ri.(� xt as liqq-tttl gp ( tC.Nt a side hereof, and agrees to install said prices
r and/or Az�dro it mdlhi �ci �vf['h�flWllrovisions of the Plumbing Code of the City of
a w Cupertino, and all other laws applicable thereto.
w x.
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0 o Use of,, Premises �/� ,/
3 Ownersmm& Z4 d t--it�i, e �..�.r J Address oL9 3 V /1f<�v� �Ccd!
o < L IC,EY SONS INC. swi CCLz`a-a)
j B P.O. Box 1204, 19µ8Cy'[ Address
§(jYTAA��Od�ITE
a 9lygO86
3
— Phone 7 — /.i�
a o State License �/,5'/ -2, � Approved WILLIAM D. H£�IF�rtre�
JI PLUMBING INSPECTOR
Heate
Valves
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough, Complete
Main Drain
Final