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NO. 1 STREF.I'
APPLICATION FOR PLUMBING PERMIT
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A i aflbhiri'aAeAP ade e City of Cupertino for a permit to install 'plumbing
o a pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
i N and/or fixture m r�p.�ly�the provisions of the Plumbing Code of the, City of
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0 LL Use of Premises. y�U
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O _�ONTRA OA,yAG LENT
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u s State Lice h,-2� �`�y Approved K/
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U PLUMBING INSPECTOR ✓
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FEES
xture
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kl, Valvcs
.RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final