51187 (2)No. Lot No
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c - LICATION FOR PLUMBING PERMIT
E CITY OF CUPERTINO
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Sanitary No.
�E SDate , 196, Permit No.�S—// eF
Fee$�S�u
Application 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 Cupertino, and all other
qlaws applicable thereto.
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q? State LicenseApproved
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Water Heater
Wash Trav I 1 II STORM DRAINAGE
Comb.Sink & Tray�� To Curb
Dental Unit
Size