1000 (2) LOT NO.
'O. r STRE ..
wk� APPLILION FOR PLUMBING PERMIT
^� \ CITY OF CUPERTINO
Date/.Z—f`/� "'"`}}}•www 1;&_ Permit No.J �oC�
Fee$� QG
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 other laws applicable
thereto.
Use of Premises /✓ "� V�
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CON7AACTOR, AGHNT
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�ti�IL • PLIIl1BIN' INSPBCTO
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r,. Cupertino Sanitary
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO�'
❑ Sewer Connection i:' ! „ Sanitary Permit No. ..,,^ .
_[f�lumbing Final Plumbing Permit No,t:lao:&...:
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UMBING INSPECTOR
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