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NO. STREE.I'
N APRT ATq.N FOR PLUMBING PERMIT / 7
CUPF.RTINO
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3 a Date vv�jJN 2.1 �96% Permit No
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Pee $ ��•
Appl�c',afipYis@f4eb�A(�yhpt('�i�} of Cupertino fora permit to install Plumbing
pipes an /or fixtures I < I ' s se 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
I avtvZI INC.
B P.O. Box 1204, 198 Commercial s+ Add
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�^ FF:�3086
Phone
State License 95� App
WILLIAM D. BENEVICH
PLUMBING INSPECTOR
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UNITS I FEES
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�prinklrr Valvcs Water Sys' Fee` -SO
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final