51187.121739' Beaven Dr.
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NO. STR I. El
APPLICATION FOR PLUMBING PERMIT
�x CITY OF CUPF.RTINO
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Sanitary No.
Wj;e . 1 70 196_ Permit No, %.
i LL Pee $ 4S
�'}Q y pl' nade to the City of Cupertino for a permit to install plumbing
a 1 p . ai d on the reverse side hereof, and agrees to install said prices
i N and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other laws applicable thereto.
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LL Use of Premises Residence
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3 Owner Jack W. Erlan
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�z By Softmaster, Inc.
CONTRACTOR,AGENT
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—Phone 379-5050
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a o State License— X2-34281__
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Address 21739 Beaven Dr.
Address 1150 Dell Ave. Camp.
Approved
PLUMBING INSPECTOR
FEES
V
Boxes
Sprinkler Valves I 1 II Water SYS. Fee
3
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final