51171LOT NO,
STREP.T
P ATION FOR PLUMBING PERMIT
CITY OF CUPERTINO
WAUG 19 196
x o Sanitary No.
° :5Date 7 1 L 196_ Permit No
CI Y OF CUPERTINO Pee S
° Application is hereby made to the City 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
> and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other laws applicable there o.
~ Use of Premises
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O0 O
3 Owner Address
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By Stuca ,/%��,�c�ryir -Z-�=C Address 2"
3 o CONTRACTOR, AGENT
— m Phone 377- 2- 7f3
w z
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atate License �Gd 38� Approve
U PLUMBING INSPECTOR ✓
I UNITS I FEES II _ _ IUNITSI FEES I
aste
Area vrains I 1 II Main Uram Pee 1 S v c
klcr Volvcs
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
'Iain Drain
Final