51220.1APPLICATION FOR PLUMBING PERMIT
C" OF CUPERTINO CITY OF CUPERTINO
JUN 3 j9
Date , 19R/
Sanitary No.
Lot No. 2--
Permit No. rl- Y31. /
P A I D Fee Syi� S -b
Application is hereby made to the City of Cupertino for a; 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 pr/oya�t�ons of th Plumbing Code of the City of Cupertino, and all other
laws applicable thereto. / i / 7,
Use of
Address
By 1 Pn&j/.LI'.[-!i '--PvrJ Address
Phone G 1
/� / ✓
� State License Approved
Plumbing Inspector
v
Dish
Floor Drain
Size
To Curb