51167a 7 a.� I V�Ct'�t-C�10 LV,E.y�C-LaLQ� LOT NO. " �—
NO. STR EEa' e L #
APPLICATION FOR PLUMBING PERMIT d
G
UPERTINO
Sanitary No.
Permit No 6
Fee S a/ A-0
Application is hereb3, made to th City of Cupertino for a permit to install plumbing
pipes('Rj1TTr (rAUreC(j ff rTt�{Lj�verse side hereof, and agrees to install said prices
and of x ure m actor ante with the provisions of the Plumbing Code of the City of
Cupertino, and all other laws applicable thereto.
Use of Premises
V w. L HICKEY SONS INC.
By, w P.O. Box 1204, 198 Co
coNTx��ro�. N�FSyAif. 94086
Phone
State License �%S/ 12 --2�
QeZ'C,�
Approved
PLUMBING INSPECTOR f
UNITS I FEES
Boxes
U
ins
nkler Valves
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final