2583 COT NO.
NO.
r 6- TI F PLUMBING PERMIT
d CUPERTINO
Z.
FFES 31964 Sanitary No.
0 /
o a Date'�`Y / 96'/ Permit No
50 CITY OF CUPERT!N0 Fee $
O Application is hereby made to the City of Cupertino for a permit to install plumbing
`o < pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
>
an fixtures in accordance with the provisions of the Plumbing Code of the City of
w= Cupertino, and all er laws applicable thereto
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Use o emises
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� 3 Owner �' Address oo, 7 7
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''State Lice s Approve
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PLUMBING INSPECCOA
DiBER MAIN DRAIN
UNITS FEES UNITS FEES"
Water Heate Sae j
Water Closets Material
Bath Tubs To Curb
Showers To Prop. Line
Lavatories . To Existing
_Kitchen Sinks Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Machines Size
Water Softeners J, Z) Material
Bar Sinks To Main Drain
Com . Sinks Trays To Curb
Dental Units _
MDn,
g Fountains
rains WTOTAL
.SYSTEM
s
nt Sinks raps OTAL Feerains ain FeeLeaders rain Feer Valves ys. Feeee L FEE 1 ,700
.
RECORD OF INSPECTION
Underground Rough...
Partial Rough..
Rough. Complete.. 't
Main Drain
Final