25062072
LOT NO.
NO.
JJi7P TIS FOR PLUMBING PERMIT
tom'! N V. Y 4 196 `L,1, OF CUPERTINO
Date �7 194.1 Permit No. U` •�O
CITY OF CUPERTiN0 Fee $ O
Application is hereby made to the 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.fiztures in accordance with the provisions of the Plumbiing'Code of the City of
Cupertino, and all other laws, applicable thereto. "
Use of Premises
'-7`7
OCTO AGENT
l/�^ Phone• Ze!'L0�
UNITS
Water Heater
Vawes
RECORD OF INSPECTION
Partial Rough
Rough Complete
Final