51167.1IL��GL=_.�YII_ ��//,L LOT NO.
NO. STIZEET
APPLICATION FOR
�y
f)a tP ..I 1,^ •n 19f�
R PLUMBING PERMIT
CUPERTINO
Sanitary No.
Permit No (a 7,
Fee $ 61'3 -�r6
Applic ljt a s E c eby }P��te��p�helCity of Cupertino for a permit to install Plumbing
pipes an Uq; xtures, lis ed. wiLthel rove c side hereof, and agrees to install said prices
and/or fixtures in accordance with We provisions of the Plumbing Code of the City of
Cupertino, and all other laws applicable thereto.
Use of Premises
0-1* ✓—
Wr
By, ��i�S6' l�nClis�� C.fl AB�rc.i .�
CONTRACTOR, AGENT—/Z—
PhoneJ��j
Approved
PLUMBING INSPECTOR /
State License
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UNITS I FEES
w
ante
rea Urams
tater Leaders
-rinkler V.Ivcs
Boxes
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final .