51226LOT NO. t!
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�!PLICATION FOR PLUMBING PERMIT
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I 0 \51 CITY OF CUPERTINO
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Sanitary NU.
Date 196_ Permit No
V v
Fee
tiApplication 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
License—Z 7 L 2,-kL:1
PLUMBING INSPECTOR
V
MAIN
Water Heater
Size
To Curb
Dental
Size
Total