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5106802 0 os/ & A LOT NO. STREET APPLICATION FOR PLUMBING PERMIT w CITY OF CUPERTINO w o Sanitary No. p 0 � Date 'GV' ..• --'y t7� Permit No /J 6O 3 u` t; Pee $ 4 Q Appli �o e e � to d}' of Cupertino for a permit to install plumbing 01 pipes and/or fixtures listed on the reverse side hereof, and agrees to install said Prices > and o es�jt ac provisions of the PlumbingCode of the City of a w Cuper ndWu ot1,y¢)iii�littibC thereto. } w x Use of Premises -t;I E'r%j/r of frc r' 00 0 3 Owner. • Address �e J/ -} a BV /%+fj�%♦ Com, �y �."�`+'�Address )30 C4"'Iyul Vi SU. n CONl'RACTOR,AGENT 3`X93- �3yo - `m Phone w z p of State License �9��/� Approved- �( a 0 UPLUMBING INSPECTOR FEES Heate ns ze V a Ives RECORD OF INSPECTION Underground Rough Partial Rough Rough. Complete Main Drain Final