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® KION FOR PLUMBING
u, < , CITY OF CUPERTINO
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PERMIT
r p (JUL 2 9 19 71) Sanitary Nu
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0 < Date 196— Permit N
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w oCITY OF� '14CUPERTINO Fee $
Application is hereby made to the City of Cupertino for a permit to install Plumbing
o < pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
I and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other laws applicable thereto.
., Use of Premises
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3 Owner Address
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0 CONTRACTOR, AGENT
3 m Phone .j `7 9- Ti 3
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a m� State License Z `� �'' e/ Approved .
I J - PLUMBING INSPECTOR v
Washer
Washing Machine
Water Softener
Floor Drain
STORM
To Curb
Fee