51157 (6)O O I -/4 /VTSu /V/Vi FI LOT NO.
NO. STREET
P N FOR PLUMBING PERMIT
CUPERTINO
Sanitary No. r
Permit No S (tel '
MUM
^^''((�� Pee $ S°0
�iycat Vis Oi�.tFi11iYM&, City of Cupertino for a permit to install plumbing
pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
Cupertino, and all other laws applicable thereto.
Use of Premises -d- (5 AWt(cpgL (I"Irl ll�
Owner s i �h• �Qk' %P/2J�iYu Address Nom • �'fIz � /�•
B %j �'bT�`Q"� r�' `9'�• Address2ti��
By
CONTRACTOR—AGENT � n
Phone 1 - 1 3 9
o !tate License 1r3 -7 't2—
U.I�dI
PLUMBING
Water Heate
rea
nklrr Va
Underground Rough
Partial Rough
Rough. Complete
Main Drain