51115'OT
NO.
NO. S'�j.T
APPLICATION FOR PLUMBING PERMIT
z a CITY OF CUPERTINO
x o Sanitary No.
3 a e / � 19VU9 Permit No 111S
W 4
! {JUL 13 1Jn7 Fee 3, 5•0
O
� Application is hereby made to the City of Cupertino for a permit to install plumbing
�" I p� cs and/ r t�o'�L7�� the reverse side hereof, and a rees to install said Hees
t i i�orbi f urd�a 0340%,ith the provisions of the Plumbing Code of the City Of
a W upertno, and all other laws applicable thereto.
W x
�r
n Use of Premises
0 0
7 N
r3 Owner—R0 -AL"lC n1A$ Address 2,012F�f4t/FrA 17e,
° _j Cupertino Plumbing
J o By CONTRACTOR,AGENT Address 20432 silvera4e s4ae.
3 `a Cupertino, Cu. 95014
— N Phone
Wz 253-0618
a o. State License Z W Z 3 Approved'"
Al PLUMBING INSPECTOR
rea
klcr Volvcs
Sewer
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final