51167 (2)LOT NO. /_�
NO.. STR IUEEEF.T
D j2! PL'ILZAT N
_�O�C, �TY
�rn O 966
FOR PLUMBING PERMIT
OF CUPERTINO
Dat 1>f>e
Cupertino, and all other laws applicable thereto.
Use of Premises
Sanitary No.
Permit No %
Pee S
for a permit to install plumbing
and agrees to install said prices
Plumbing Code of the City of
I
D Vicaoi isCUybERTIW'Dhe City of Cupertino
pipes and/or fixtures listed on the reverse side hereof,
and/or fixtures in accordance with the provisions of the
Owne/- /iJLiYi,ii Address %y��-o'✓JJ� / %.
By 7/12511 /!�/iA,r4/.,..A-ii Address
CONTRACTOR, AGE
'State License
17 -
PLUMBING
PLUMBING INSPECTOR v
vatunes
Ins
PrA
Boxes
UNITSI FEES I
Area Urams MamUra n Cee
��/ater Leaders Storm Drain Fee
Sprinkler Valves Water Sys. Fee
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
.Iain Drain
Final