2685 a/ r
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NO. TR
D I OR PLUMBING PERMIT
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.f APR 15 796
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O -4 Sanitary No.
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3 U Date 196— Permit No (-/2J�/
W QTY OF CUPERTMO - Fees_
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QTY Is hereby made to the City of Cupertino for a permit to install plumbing
0 a pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
r and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
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Cupertino, and all oth aws a plicable theret -
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3 Owner /LR K 4o ie Address-
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0 P1.I711HING INSPECTOR
—FIXTURES
UNITS FEES UNITS FEES
Water Hence Size
atV to CTOsets Material
Bath Tubs To Curb
Showers To Prop. Line
Lavatories To Existing
Kitc—to—nnks Not Conn.
Dis�ers Sewer Boxes
Waste Disposals
X asTU 'h Trays STORM DRAINAGE
Was mg Machines Size
Water So(te a 3t^ Material
Oiinks To Main Drain
Tow rays To Curb
Dental Units
Drinking Fountains
Floor Drains WATER SYSTEM _
oppi� ,ers Size
Restaurant Sinks KMain
San rapsTAL FEES
rinses— e
rea rains in Ieeater Leaders in FeeSprinkler valves . FeeTOTAL EE
RECORD OF INSPECTION
Underground Rough...
Partial Rough-
Rough. Complete..
Main Drain
Final...