1706 No. s4aEEr LOT NO.
LTION FOR PLUMBING PERMIT
If1 rFlq1-4-;L
OF CUPERTINO
Dat Permit No.
' C71
Fees S9
QP11 ib [is Ap[Une
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 allotherlaws applicable thereto.
Use of Premises 'p lea ezz- �ir_ 'i[..ln* rltd
r
:a
Owner �g ve 49, Address
Address
CONTEAC0jENT
Phone •p- — y Approve
PLUMBING INSPEC iB
J
�i�I`URE B R M N R
UNITS FG ES UNITSI FEES
'Water;Heater S 6,0-6 Size
Water -C osets 7 7,16 Material
'Bath Tubs �/ yo0To Curb
'Slioweis To Prop. Line
-'Lavatories $'0�� To Ex
Xitchen Sinks // sloop Not' Conn. 7 00
Dish Washers
Wast; Disposals
`Wash Trays STORM DRAINAGE
_Washing Machines � I /0p Size l
W� at@r Softeners Material
;Bar Sinks To Main Drain
'Comb. Sink_g'�Traysl 1 11 To Curb
Dental Units j
Drinking.Fountains� �I
I Floor Drains �l WATER SYSTEM
FIgP1 Rers 11Size
Iaestaurant Sinks I 1 11 Material
Sand Traps TOTAL FEES
in Is IL Fixture Fee 1 1
":Area Drains �I Main Drain Feep
`.Watci leaders I Storm Drain Fee
i Sprinkler Vaives ,II_ Water Sys. Pee
i' Permit Fee
:TOTAL Ia4 OSI TOTAL FEE 3!
ECORD OFINSPECII N
Partial Rough
Rough ComplcZq4z
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