51155NO.
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gl�JIMLI FOR PLUMBING PERMIT
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f APR 15 sanitary No.
Date196— Permit No
[[�� ����((�� Fee $ �-
A �lt�; i a on rcQPERTIIP city of Cupertino for a permit to install plumbing
pipes aln or xtures 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./
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Use of Premises -Li� C
Owner/!/y
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�f'� CONTRACTOR, AGENT
Phone Wall
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a tate License A
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PLUMBING
V
FEES
ns
kler Valvcs
Boxes
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final