51175.1ii
F
LOT NO.�
NO. STREET
APPLICATION FOR PLUMBING PERMIT
z ` ��-_CITY OF CUPERTINO
£o i. \s-��r _�I Sanitary Nu.
a
0 J Date eIY-- ^96_ Permit N , ` 1 a '—
u K J. b 196] Fee $
T w
Application is hereby made to the City of Cupertino for a permit to install plumbing
pipes at
d�Tr/hxtures IisFe�iron helc��erse side hereof, and agrees to install said prices
and/or Fxhues to accordancLrw th (h _provisions of the Plumbing Code of the City of
Cupertino, and all other laws
lawslappp�licaable thereto.
Use of Premises - t L}� -_-- -
t n /:
Owner
D
CONTR CTOR, AGENT
Phone � -m-
State License7
UNITS I FEES
SU
nkicr Valves
Boxes
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final