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ggST E �
p �'Z'dPPL 6' T FOR PLUMBING PERMIT
" OF CUPERTINO
w p r1 9964 . '
x ° Jt1-' Sanitary' No.
0 a Dag 'l945,� Permit No `S
w� N 1) Fees / .00
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° Application is hereby made to the 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
> 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.
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g LL Use of Premises ti
00
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,Q oStafe Licen`sc! S'�'lt�-_ Approved —
�U '- •,/ PLUMBING INSPECfOA
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