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�PL� FOR PLUMBING PERMIT 5
® f�V OF CUPERTINO
O1 Sanitary No.
6682
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3a K L 19iZQ Permit No
.0 Fee 5 Z-57
,0 dtt�tic rfl6s h • City of Cupertino for a permit to instill plumbing
o pip an /or Ixtures listed on the reverse side hereof, and agrees to install said prices
> ra- and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other llajaa�ws applicable thereto.
LL Use of Premises
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,�. is Owner aZgLW 1190hfefl . JW61 Address
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By 6,80eaLL�7� 6i . Address /W Tit/. !�✓�/�
3.F 9%N'IRAC�5I'OR,
w i Phone 4%d' 7—'�-�D y�
FFa., o State License Z" 99� `' Approved /
tyU ` PLUMBING INSPECTOR �/
Dish Washer
Comb.Sink & Tray I 1 II To Curb I I
Drain
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