51211U J /Y(. _ CC.ct-A , LOT NO. 13k D — L—
NO. STR EF.a'
m VFOR PLUMBING PERMIT
Y OF CUPERTINO
® Sanitary No.
Permit No
CDT Nn Fee $ .2 3 70
Qc{�(Q titOr I�j�FGa�BL� MQe City of Cupertino for a permit to install plumbing
pip a i /or fixtures listed on the reverse side hereof, and agrees to install said priors
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 L(':, t
o
Owner
By
CONTRACTOR, AGENT i
Phone 3i9-3393
State License IZ S V (=Y 3
Address `�3S %LIn�..,.,,'f 6-6,
iso
7-24-30
Approve J
PLUMBING INSPECTOR �/
FIXTURES I NUMBER II MAIN DRAIN
Water Heater I/(o I Size C6 r' 1 1
Comb.Sink & Trav I 1 II To Curb I I
Unit
Total Fee