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NO. STREET •-e - '
�APPLiL&ATIOWFOR PLUMBING PERMIT
44 CITY OF CUPERTINO
Dat? AUG 3 0 1952 195_ Permit No. /76/
CIT, OF CUPERTINO Fee$
App ication Is hereby made to the City of Cupertino for a'permit to install plumbing
pipes and/or fixtures listed'onAhe reverse side. hereof;'and.agrees to install said prices
and/or fixtures in accordance with the `provisinnsof the Plumbing. Code; of the City of
Cupertino, and all'other lawsiappli&ble theretyo
' Use'of'Premises A✓ if 'G/�itdt '\ ' l ��.
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INSPECTOR
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FIXTURES NUMBER
MAIN DRAIN;;hy:v;
UNITS FEES
IUNITS hFEE9;
Water, Heater I
) Size I {
Water Closets
Material f -,
Bath Tubs -
To Curb
Showers
To Prop. Line - ;,-;>. . •,��,
Lavatories
To Existing`: t ,�; ,• ;�
Kitchen Sinks
Not Conn. y"
Dish Washers I iI
SEWER BOXES °J,�'•
Waste Disposals
Wash Trays
STORM DRAINAGE
Washing Machines
I. Size �'•':' „I!a `'
Water Softeners
II Material
Bar Sinks, ' ;)?n ., .
To Main Dr4iirel"^,`,
Comb,. Sink.& Trays) ' ' :. I
To Curb `'"'r_""�; ,:.-- $'%a • R
Dent I Units
Dfih ing Fountains)
Floor' Drans
II WATER SYSTEM
Hoppers
Size
Restaurant. Sinks
=Material
Sand Traps
TOTAL FEES _ t
Urinals
Fixture Fee'., i
Area Drains
Main Drain Fee
Water Leaders
Storm Drain Fee
SprnklerVaivc
Water Sys. Fee
ACuJM 2Etf —
Permit Fee .
TOTAL I 1
II TOTAL FEE
RECORD OF INSPECTION
Partial Rough r
Rough Complete A•
Final n