51189 - Pool #3`O \ �3O I !6 \� ~�1 ,_ \['P3�..�`^� LOT
NO. STI EE.I'
CITY
aF a� A�,
PPLICATION
1 4 N9
Uaty (�'A\�
PI
OF CUPERTINO
FOR PLUMBING PERMIT
Sanitary No.
19Permit No
oo Fee $ Aete 9 E—
ApplTation is hereby made to the City of Cupertinofor 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 provisions of the Plumbing Code of the City of
Cupertino, and all other laws applicable thereto. `
Use of Premises U)%Mt-!&1,t3 C'�C7CS)\
OwnerAlts--1""� Cy C -r
By
CONTRACTOR,AQENT
Phone
;tate License 1\1 %\-
Addresslm- Cas.?-() LIEU-,)
Address '�\O tit0�• IZ
Approved W'LL1AM D. BEi1EViCFf
PLUMBING INSPECTOR
Water Heater
STORM
Comb.Sink & Tray�� To Curb
Dental Unit
Material