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APPLE Tl ..JR PLUMBING PERMIT
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o Date 19 Permit No
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o Applicattgri P(heRFmfdcjhoFfhd 1i ylbt Cupertino for a permit to install plumbing
o i-pipesand/or fixtures listed on the reverse side hereof, and agrees to install said prices
r I 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.
Address 30,
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PLUMBING INSPECTOR
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Address 30,
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Approved
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PLUMBING INSPECTOR
Water
_ LUNITS I FEES 11 1UNITS I FEES
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RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final