51169 (4)/D 6
U v
N D ON FOR PLUMBING PERMIT
a CITY OF CUPERTINO
w `iFEB 2 5 1966
r p Sanitary \p. _
0nrL� ��� Z1 196 6 Permit No
w LLUlr' I Fee S �
xo
Application is hereby made to the City of Cupertino for a permit to install plumbing
o a pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
i m and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
aw
Cupertino, and all other laws applicable thereto.
Co
Use of Premises / 2
Owner v //'bC"t
By.
p CO ` RACTOR, AGENT
Phone - / — -X S-.
State License '2 -
Address A/. 9 q- x'-';"'-'r)�/ �
Address' S 1'0, s-, Al
Approved
PLUMBING INSPECTOR
V
ater
Area Urams I 1 II Main Drain Fee I .j
ler Va
%r RECORD OF INSPECTION