1904 . LOT NO. �I
j �RAPPLICATION
F.OR PLUMBING
PERMIT
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TY� RTINO
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Datet G gtt�9 Permit No. O�.
1 �r. 1��
� r•; . ;=_ Fee $
Appliiation is hereby made to the City of Cupertino for a permit to install plumbing
pipes iod/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
J` `Cgpdrtino,.and all other laws applicable thereto.
8 s
L' ;Use,pf'"`Piemiseso
h.. Owner%S/ /J
Address C
By „a_ ���� Address +: GC fGa.
f +�..'C`.�' CONTAACTOR�•AGENT �
Pet Approv
PLUMBING INSPECT A
1-
URES N r I R I
I UNITS I FEES IUNITSI FEES
Sir
Wsmr Hcater
Water Cosets 3'
Aath Tubs I / I/ II o���;��, I ' "^ `•
Showers I / Td 1?rop. I]Y�e. �.' ,•.,z+,'� _
Lavatories To`E' tmg.;.'
Kitchen Sinks ISI t Con �..�
Dish Washers i /. I SEWER BOXES
Waste Disposals l I ��
•Wash Trays I STORM DRAINAGE
Washing Machines / l Size F I
Water Softeners I Material l 1
Bar Sinks II To Main Drain I
Cotnb. Sink&Traysl I II To Curb
Dantal Units I I I I_
Drinking Fountains)
Floor Drains I WATER SYSTEM
Hoppers I If Size
Restaurant Sinks I II ;Material I
Sand Traps l I Il TOTAL FEES
Urinals l l ll Fixture Fee, ja 4k_
,Area Drains I I Main DrainFee I ,4%.j
Water Leaders I I it Storm Drain Fee
Sprinkler Varves I I I
Water Sys. Fee p tj
_I Permit Fee 101 4- r "
_TOTAL Ij: II TOTAL FEE �• aci
RECORD OF ION t
Partial Rough
Rough Coml
Final —
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