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NO.
APPLIION FOR
OF
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Datev r DO-6�
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PLUMBING PERMIT
CUPERTINO
Sanitary No.
Permit No
Fee 3. 3._So
Application,hereby �rttad jhh(¢ity of Cupertino for a permit to install plumbing
pipes Th r fiVures�h�iedtor� lh��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 lawsapplicable thereto.
Use of Premises
Address V S -741p*•
PLUMBING INSPECTOR ✓
Water Heate
I UNITS I FEES It .IUNITSI FEES
z
Urinal'sFixture Fee
Area Drains �Iyfain Drain Fee �� U
Water Leaders -�n Fee I
Sprinkler Valves I 1 II Water Sys. Fee I / d—o
RECORD OF INSPECTION
Underground Rough...
Partial Rough..
Rough. Complete..
Main Drain
Final...