51231.1I DLOT NO. -67-J/
NO. MEE.I3 1+ 13 ,R
APPLICATVON FOR PLUMBING PERMIT
W a CITY OF CUPERTINO
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0 U Uate,WN 8 19735 ',./e 19�./ Permit No S / �— 3 �•
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a "J--bn Fee $
O ApliarAn it hay made to the City of Cupertino for a permit to install plumbing
a a pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
i I and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other I , , pplica le thereto.
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a Use of Pr 'ses
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02 State Licence
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Approved
PLUMBING INSPECA
Closet
Dish Washer
DRAINAGE
Water Softener I 1 II Material I I
To Curb
Water