2006 (2)J
® A.P-PPVICA I ` M FOR PLUMBING
Cf Y OF CUPERTINO
AM 5 1963 � Sanitary
NO.
PERMIT
Date 196— Permit No c2//040
C1TY gsF Q'y[TT TING Fee 5
App kation is ere y ma e to the City of Cupertino fora 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 Codepf.the,City of
Cupertino, and all other laws ap&able_theret%
Use of Premises
Licen's`e
+- 1
Address `7��G/?�/-•>� t-Lr�,
>�t�Approve
P
PLUMBING INSPECTOR
NUMBER
Water Heater I� Size'•' -,''l;?. .moi'
Water Closes Mater;al � r, r--.
is
�avaw,uo
Kitcheh Sinks
Dish Washers Sewer Boxes ..'."
Waste Disposals
t
n Fee I.:,,
I ' RE -CORD OF INSPECTION .. ^•�