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NO. STI EE.T
IP
OR PLUMBING PERMIT
P CUP'RTINOSanitary No.
Date 1(9,�6— Permit No
�I tb U V U%RT(14-Q Fee $
AP t n ere } a i rty of Cupertino for 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 Premises ice C>`ea wr '7`'a * r_
Owner r Na I/ o A eo
B yAf(�rfi� �l�
CONTRACTOR, GEN;
Phone Z 7A—.3,;' S-9
State License —�7 ye e3 2-
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Address /00%/ FG�S%%�S AD`'
UNITS I FEES
aSte
(I,kl: 'r Vjl,V S
RECORD OF INSPECTION V
Underground Rough
Partial Rough
Rough. Complete
'Iain Drain
Final