NO PERMIT NUMBERNO. STREET
MIN
PERMIT
JU� ° 19689 i l Sanitary No. Date /� )) 1942 Permit No
r- ° V ��' P:1 i�rDTl I Fee $ #i,3
App ication is hereby'made to, tGe. Caty;toOCupertino 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 thereto.
Use of
Phone
State License
Address�G�%��
Address �"�� ✓
Approve (/
PLUMBING INSPECTOR
FEES
Water Heate
ns
Spnnklcr Valvcs I 1 11 Water Sys. Fee I /.5 -
RECORD OF INSPECTION
Underground Rough...
Partial Rough..
Rough. Complete..
Main Drain
Final.--