51167.1N a
W 2
ILOT NOS=!
NO. ST EFI'
APPLICATION FOR PLUMBING" PERMIT
CITY OF CUPERTINO
((j/ Samitary No.
J'
Date. "E79(� Permit No 7, /
..
t4ppli atiop,_is �herebypr adeltolthe City, of Cupertino fora permit to install plumbing
pike; and/�rtfixture-Y ted UTihe 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
Phone
WILLIAM D. flETQEVICH
State License Approved
PLUMBING INSPECTOR (/
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final