14441.t= .LOT NO
NO. srREaT
PCATION FOR PLUMBING PERMIT
D D OF CUPERTINO
1� Permit No.—
Fee
o. Fee S
C1V41n{GonWW1 tl!{ib 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 primo
and/or furfures in accordance with the provisions of the Plumbing. Code of the City of
Cupertino, and all other laws applicable thereto
Use of Premises �/� /QLD • �✓
Y
y Owner
y SOFT WATER SERI"
J�1040 Lone. nGaNr
one Eym..t...il r
Address
Ad
Approve -
PLUMa7 c Msp a
Ult D
UNITS I FEES II
UNITS I FEES
Water Heater I�
Site
Water Closets
Material
Bath Tubs
To Curb.
Showers
To Prop. Line
Lavatories
To Existing
Kitchen Sinks
Not Conn.
Dish Washers
Waste Disposals
Wash Trays
STORM DRAINAGE
,Wfirn"f Machines
Size
Water 5QEw"a
Material
B ra Si ks
To Main Drain
Comb. Sink & Trays
To Curb
�I
Drank ni g Fountains
Floor Drains
�� WATER SY—STEM�
Hoppers
Size I I
Restaurant Sinks
Material
S—anT1'raps
TOTAL FEES
Urinals L_��
Fixture Fee
Area DrnmsMain
Draih Fee
Water Leaders
Storm Drain Fee
Sprinkler Va+ves
Water Sys. Fee
i6WRR eoxe
Permit Fee
TAL
TOTAL FEE
RECORD OF INSPECTION
Partial Rough
Rough Com let
Fina Z