51139.265 -
NO.
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1
LOT
STAE.P.T
APPLICATION FOR PLUMBING PERMIT
CUPERTINO
Sanita R' No
Date T�C=1�O� l l�6— Permit No L // �-
Jam_
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Aprp�'Tayonprhera����f;RTIttim-�ity of Cupertino for a permit to install plumbing
pipes and/or rxtures liste�df--A their verse 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 otherkvs applicable thereto.
Use of
I UNI KAU I UK, AULN r
Z�lt —7/ e%1
�State License,V J z
'ApprovedL
PLUMBING INSPECI0
ns
rinkler
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final .