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FOR PLUMBING PERMIT
(j�Ah I OF CUPERTINO
Date ®" rx 0 144 Permit No. llaoW
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Fee $
Applicatioh.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 other laws applicable thereto.
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PLUMBING INSPECTOR
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