51179M—eICF� ABEL LOT NO.
NO. STFEE'r
APPLICATION FOR PLUMBING PERMIT
W a CITY OF CUPERTINO
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DatPermit NoUL { 29 1970 Fee
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Application is hereby made to the City of Cupertino for a permit In install plumbing
o , pipes and/or fixtures listed on the rev, Se side hereof, and agrees to install said prices
i a and/or r) �rx 4) c FERT '�,lrovisions of the Plumbing Code of the City of
a�Cupertino, an all other aws applicable thereto.
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5: 3: Owner�,q,L_A k6ir� Address/9411 Q KE,
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3 F ^ CONTRACTOR, GENT
—am Phone 02����9d
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a 7 (State License.' / �J J Approved /
PLUMBING INSPECTOR ✓
NUMBER
Water
Dish Washer
Floor
STORM
To Curb
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Fee