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,22�3o6 I DE 19 tj7-.4 Q12C.t4F- LOTNO. /
NO. STIIEEI'
APPLICATION FOR PLUMBING PERMIT
CITY OF CUPS �I\O'I\��j'
Date 4-.2 19 8'1y'(
Application is hereby made to the City, of Cupertino for a permit to install plumbing
pipes and/or fixtures listed on the r rsid Mere 1 t �j install said prices
and/or fixtures in accordance with th�}ovisibs — ?A P�u'rdtiitig�C:bde of the City of
Cupertino, and all other laws applicable thereto.
er
Use of Premises wC e e /n3 C�
By S'�-w V; so rd—
CONTRACTOR,AGENT
Phone 9 -?3 0/75?
State License .20 y- V&-0
Address 22,106 OF4a7.,9 &R,
Address /yS /,N Co4./ll /Qae
WILLIAM C. EENEVICH
PLUMBING INSPECTOR
Water Heate
Water Clos
rea
ler Valves
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Hain Drain, = 7 1