1852 •'L� LOT NO.
p R PLUMBING PERMIT
N
wZ I OF CUPERTINO
IN
191992 ` _
� o .' NOV •- Sanitary No. �� _
3 < Date 196_ Permit No. i� Z y"
1 LL CITY OF Ct1P Fee$ U O
' 0 Application is hereby made To•OPty of Cupertino for a permit to install plumbing
o` a pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
i to
< and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
< w Cupertino, and all o laws ap iable thereto.
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Use of Premises
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o a Owne Address
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o By q Address
— Phone 1 0
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aState LicenseApproved Cl'
CONTRACTOR, AGENT
UNITS FEES UNITS FEEs
Water Hunter SIZe r
Writer Closets Material a.
Ila h Tubs To Curb
Showers To Prop. Line
Lavatories To Existing
Kitc en Sinks Not Conn.
ish Washers SGW"—Bares
Waste Disposals UAiYh
STOR DRAINAGE
Wash Trays
Washing Machins Size
Water Softeners Material
Bar Sinks To Main Drain
Comb. Sink x rays To Curb
Dental Units
Drm Ing rountains
P oor Drains WATER SYSTEM
Hoppers Size
Restaurant Sinks Material
San raps TOTAL FEES
Urinals Fixture Fee Q
Arun rains Main Drain Fee Q
Water Leaders Storm Drain Fee
'Sprinkler Vorocs Water Sys. Fee Q
Permit Fee 12
'TOTAL TOTAL FEE I AA
RECO D F SPECTION
Underground Rough...
.Partial Rough.. 2
Rough. Complete..
l4ain llra'n _ y c�
Final... '; �' _
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O 7
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