51129l / 910z 4a,. LOT
NO. STBEEI'
P N FOR PLUMBING
OF CUPERTINO
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PERMIT
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A>p1���tiV r is$,JR #4 City of Cupertino for a permit to install plumbing
o a pip o tur este 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
a w Cupertino, and all other laws applicable thereto.
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Use of Premises �' �✓•
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Phone
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Q�State
License
Address
Address
Approve
PLUMBING INSPECTOR /
Water Heater
Wash
Comb.Sink &
Dental Unit
MAIN
Size
Material
WATER
Total Fee