1592 C" LOT NO � 4
NO. STREET
D R PLUMBING PERMIT
I F CUPERTINO
JUN 2!q 19 22
Date 9� Permit No. l r Z
TY OF CUPERTINO Fee$
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 laws applicable thereto.
E Use of Premises--2 U ( (S
'a
Owner W i Address
By Address
CONTRACTOR, AGENT _
Phoner S` �69z/ Approve
PLUMBING INSPE O
UMBER MAIN DRAIN
UNITS FEES UNITS FEES
Worer Heater 1 3 1 11 Size
ater Closets 3 Material C,D,
Bath Tubs To Curb
Showers To Prop. Line,
Lavatories 3 1 11 To Existing
Kitchen Sinks 3 �� N
Dish. Washers I IIgEWER BOXES
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Machines Size
Water Softeners Material
Bar Sinks' To Main Drain
Comb. Sink n raysi To Curb
Dental Units
Drinking Fountainsl• �I _
Floor Drains WATER SYSTEM
Hoppers Size I_
Restaurant Sinks Material ,
Sand Traps TOTAL FEES
Urinals Fixture Fee U —
Area Drains �� Main Drain Fee
Water Leaders Storm Drain Fee
Sprinkler Varves Water Sys. Fee 90
Permit Fee b0
TOTAL 5 _ TOTAL FEEn�4>0
R CORPOr IN 'ECTION
Partial Rough
Rough Complete ya
Final