51121LOT
(rAPPLIC-A\TION FO,Ry PLUMBING PERMIT
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` CITY 0141 GUPE•RTINO
x o(JUL 22 1968 sanitary No.
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0 a Date 196 Permit No Ski b�
3 OF CUPERTI.NO 3 Z)
Fee $ S
0 Application is hereby made to the C,tY of Cupertino fora permit to install plumbing
`o a pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
iI and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
in
a w Cupertino, and all other laws applicable thereto.
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LL Use of Premises
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� 3 Ow er 7 Address /O/ 7/ dS4 ;2-c4°Cr�
oz D Lel / Address ?9,(-
O CONTRACTOR, AGENT
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—m one o?17— kleq 7
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a o �""` Licence - . Approved IAKI�a�
PLUN113ING INSPECTOR
Water Heate
ns
V. Ivcs
Final
nes
OF INSPECTION