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LOT NO. 3
NO. fff .F.i' ���' =* 2 O�
TION FOR PLUMBING PERMIT
- CITY OF CUPERTINO
Sanitary No.
W, 196— Permit No. 5^/d Y.
Pee $ c;7—o42
made to the City of Cupertino for a permit to install plumbing
ted on the reverse side hereof, and agrees to install said prices
> : and/okAetuYes in accordance with the provisions of the Plumbing Code of the City of
a w Cuand all other laws applicable thereto.
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O CONTRACTOR, AGENT
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a o State License
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Address
Approve _
PLUMBING INSPECTOR
FIXTURES NUMBER �� MAIN DRAIN
Units FeesIlnirT cFe��
Size
Dish Washer
STORM
Comb.Sink & Trav I 1 II To Curb I I
Unit
SYSTEM
Total Fee
0