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51145 (4)x '�/64r/ I f�CG.✓,sr eT '�D A%9 / LOT NO. NO. STREET ' N Q AaP LITION FOR PLUMBING PERMIT w i ,t © OF CUPERTINO r 0 Sanitary No. 0 4 3 a Uate SEP I� . P96_ Permit No U /n = 4 Pee $ ° APlhh{Mtjypl]`,{Jgpjythe City of Cupertino for a permirto install plumbing o a piP aid/otrflxtu�h�il�t[��htiFi reverse side hereof, and agrees to install said prices Z and/or fixtures in accordance with the provisions of the Plumbing Code of the City of a w Cupertino, and all other laws a plicable thereto. w x , � r 4 Use of Premises 0 0 (/ r>- 3 Owner RG�.w _T ti/ASrw Address 0a ZJ gg z By ry Address ° CONTRACTOR, AGENT 3 r — W Phone %��'� —4//, W / 0u2 l State License --==,•-4 Approved��-c.J ,, I PLUMBING INSPECTOR ate[ rea Its k lrr Vclvcs UNITS I FEES Fee RECORD OF INSPECTION Underground Rough Partial Rough Rough. Complete Main Drain Find