NO PERMIT NUMBERNo. Street Lot No.
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® "MZA—L ON FOR PLUMBING PERMIT
c1 TY OF CUPERTINO
f SEP S 1988 Sanitary No. 153&&
Orl 1�6_ Permit No.
l� /y
Fee S /
Application is hereby made 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 therglo. _ i '.&*� � _
Use
By
State License A'o!V %r'3—
Address / 1 71 f a /
Approved
Plumbing Inspector
NUMBER
Dish Washer
Machine
STORM
To Curb
Material
Water Svs. Fee