51189 (5) 26311 ���il .
NO. Street Lot No.�
® /1\JA@PL ON POR APPLIANCE PERMIT
(�e� City
of Cupertino C,
u DaPcrmlt No. 51 /a
$ • Fee S .sa.
A ;��.�,,•"�f��I�—' ally of Cupertino for a permit to install Ps appliances as
lis e'd on lh3"mveM1W .areas to install mid appliances in accordance with the
`o provialons of the Plumbing Code of the City of Cupertino, and all other laws applicable
5 D thereto. ^
$� Use of Promises r
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z � Owner • Address
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S By , Address
Contractctor, gent
Phone
State License 132at!j 7 A::` Approved bing Inspector -)/ v
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