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APPLICATION FOR PLUMBING PERMIT
'YIyO CITY OF CUPERTINO
QiY CF c_t �
Lot No.
SEE Sanitary No. O
Date 11 1196— Permit No./d
P ,A P Fee $ 7/lO !
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 ap
Use of
Owner
by
Contractor, Agent
Phone -.-4;22 -2-S-7
State License 10 ./
Approved
Plumbing Inspector
Machine
Fountain
M
I I . 11 Permit Fee I C'A