51226I,✓I" LOT NO.
NO.t
TION FOR PLUMBING PERMIT
CITY OF CUPERTINO
r \, .9, Sanitary No.
3 a ISA 0 196— Permit No J t Z1
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(�� GV Fee S2$50
0 0 pad is hereby made to the City of Cupertino for a permit to install plumbing
es and/or fixtures listed on the reverse side hereof, and agrees to install said prices
r and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other aws applicable thereto.
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Use of Premises
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0 3 Owne
OCONTRAC R, AGENT
3Q 9Yi
— � Phone ,3�� �
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a State License /�r kZj Approved r�
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PLUMBING INSPECTOR
Water Heater
Waste
Size
MAIN
Comb.Sink & Tray To Curb
Dental Unit
Drinkin¢ Fountain
Water Sys. Fee