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LOT NO.
FOR PLUMBING PERMIT
OF CUPERTINO
r 1 Sanitary No.
Date FEB n 196` Permit No,_¢S_✓rL
_ Fee $ 7
e�ppli4titQ�s h�eby Re to 'the City of Cupertino for a permit to install plumbing
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
Cupertino, and all other laws applicable thereto.
Use of Premises
Ownet-'/'�—f Address
By "- ('- Address
CONTRACTOR,AGENT
Phone
State Licens G `'_ Approve
PLUMBING INSPECTOR
UMTS I FEES
i rr'v
n5
a --U
Water Leaders I Storm Drain Fee
Sprinkler Valves Water Sys. Fee
RECORD OF INSPECTION
Main Drain
_ .blde. Depi
: Copy
BUILDING INSPECTOR'S OFFICE
CITY. OF CUPERTINO
Sewer Connection _ Sanitary Permit No.c.G.1-..........
Plumbing Final^�-_-�
Plumbing Permit No_�=.-.,L...:.-E:..........
.. i` Lot No. �;---
1.
- Owner or Tenant ...- ``"�-� _� -_
At ... b c� �"1
Tract ..--dry
Q 19.`�.
Date Connected ---- `''Z> - ------
--------- -
. Date Final ---------------------------------'---. 5..'.:a � ..: '- - ..... 19..7 -----
PLUMBING INSPECEO'R�-'-
111 7/63-1M - -