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APPLICATION FOR PLUMBING PERMIT
R1, CITY ON CUPERTINO
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(�A hP11ca iUr• is+herg4y�jnade�to the City of Cupertino for a permit to install plumbing
pipes it: JV fixtures}isttR]T,)n tF?e 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 alyc�ther laws applicable theret(/
Use of Premises
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o State License
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PLUMBING
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xture
Boxes
Fee
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RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Alain Drain