51172I O r3,) — I M C I��%� LOT NO. _
NO. MEE.I'
N TPP ON FOR PLUMBING PERMIT
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TY OF CUPERTINO
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o Sanitary Nn1196/- Permit No ��� 90
o [41liica i isNPERTINOhe City of Cupertino for a permFee
it to install plumbing
'o a pries 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
a w Cupertino, and all other laws applicable thereto.
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ao Use of Premises ._ I-P_.J_Ld c -l) 7, w t — dale y
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a Owner_ __f _ � c: 4-j:)�1 is / I Address c)—ei d -7,i- 62-t,!�Dt-
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J o By =_ `� +L� Address a J �c 2c,044a .
3 F CONTRACTOR, AGENT
— `m Phone
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a o State License nWnt� Approve /
ll /hJ ����Q S/ PLUMBING INSPECTOR ✓
2
Boxes
Main
Sprinkler Valve's I Q 11 7—�E 11 Water SYS. Neo
Fee
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Plain Drain
Final