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1824 { 1 Z- • T C YT � LOT NO! ` `-/ No. a i D APPL A W FOR PLUMBING PERMIT IV OCT 101962 1TY OF CUPERTINO O�Se� —OF CUPERTW, 1�Z Permit No. 2 I 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. aUse of Premises Owner AddressW By AddressCONTRACTOR, AGENT Phone.�1�1( — 3 7 'Approve PLUMBING INSPECT FIXTURES NUMBER MAIN DRAIN UNITS FEES UNITS FEES Water Heater I eo I Size Water Closets I &0c, Material C.G Bath Tubs I/, ) II To Curb I Showers / /�ya I To Prop. Line I Lavatories I , Oo To Existing Kitchen Sinks h. e o No Con fj z Dish Washers I / SEvIER BO I 00 Waste Disposals / I Wash Trays I I STORM DRAINAGE Washing Machines,j / I/,p d II, Size Wate( Softeners I I Material Bar Sinks To Main Drain _ Comb. Sink a Traysl 1 II To Curb I •,---4- Dental Units Drinking Fountains) I II Floor Drains II WATER SYSTEM Hoppers I I I Size T Restaurant Sinks I II Material C C- I I Sand Traps TOTAL FEES Urinals I Fixture Fee ;-O' b Area Drains I Main Drain Fee ,;jr 00 Water Leaders Storm Drain Fee Sprinkler Valves I Water Sys. Fee I / r/m'0 Permit Fee jjj 0 0 91.!iO4 TOTAL I TOTAL FEE /g, .B c) RPOID) OF INSPECTIONPartial Rough �Rough Co toPFinal - w