1311 (_x/ � L LOT NO.
NO. STREET
e R PLUMBING PERMIT
® Chj CUPERTINO
Date 4:2- t9f Permit No. /E�-
CITY OF CUPERTINO Fee $ /
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 fixtures in accordance with the provisions of the Plumbing Code of the City of
Cupertino, and all o laws applicable thereto.
Use of Premises
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PLUMBING INSPEC OR
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