51226LOT NO. 1/
150. R,' 31341 1
.,, AP DATION FOR PLUMBING PERMIT
CITY OF CUPERTINO
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° 196— Permit No �/ ZZG
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V�` ` V Pee $ 2:150
'- ° 1>>li utiohWhereb made to the Cit of Cupertino for a permit to install lumbin •
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° etp VP/or fixtures listed on the reverse side hereof, and agrees to install said prices
l'„anH�or fixtures in accordance with the provisions of the Plumbing Code of the City of
a w.4 Cupertino, and all other laws applicable thereto.
j LL Use of Premises
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CONTR TOR, AGENT
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a �, State License //•� Ya Approved
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/� PLUMBING INSPECTOR
FIXTURES (NUMBER II MAIN DRAIN
Size
Dish Washer
DRAINAGE
Comb.Sink &Trav I 1 II To Curb I I
Floor Drain I 1 II WATER SYSTEM