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No. Street , Lot No.
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fir- ���` APPLICATIONCITY OF CUPERTIINO NG PERMIT
dc' 41
i. Sanitary No.
Date , 1J6_ Permit No.
O�
Fee $-Z
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 the 4 w _
Use or Premises
41.::�
Address BAddress
Co tractc,F-AgP
State License d/ Appro
Plumbing Inspector
Dish Washer
Material
To Curb
Total Fee
Units I Fees
N Q
W Z
LOT
NO. STREF.I'
APPLICATION 'FOR PLUMBING PERMIT
_L CITY SOP CUPERTINO
) I�`�, Sanitary No.
;ry C J
IJate "✓I NDV –�- i4FR
j
I'I6— Permit No
Pec 5�,�—e�
Application isjhereby+mndeLLto-thelCity of Cupertino for a permit to install Plumbing
pipes ah41 Jr fxturesifistWtZi thelieverse 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 Premises
Owner "re ,L.yZ - 2A3, d�-l�leGIto
Bye,Vlf1 -Na6r1es
CONTRACTOR, AGENT
Phone 7/�i i/L� s590
State License
Address/ODY/- 3-J, is Na Y
Address-3f9./Y. i/dHe�irt�tG
9Hah. P1-;,-7 P NLS
112 -MRM
PLUMBING INSPECTOR
FEES
Heate
rinklrr Valvcs
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Alain Drain
Final