796 (2) LOT NO. •�7
' R APPLI ION FOR PLUMBING PERMIT
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11i.;)' 1960 :CITY OF CUPERTINO
,, De 190 Permit No. 9
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Fee $ /
Application is hereby made to 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 prices
and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
Cupertino, and all other laws applicable thereto.
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Use of Premises ✓
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Owner Address Ze;7 7
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By S' _ Address
CONTRAC NT
Phon —D; Approved
PLUMBING INSPECTOR
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hIX URLS NUMBER MAIN DRAIN
UNITS FEES UNITS FEES
Wntcr Hcater Size
Water Closets • Material
'Bath Tubs .� To Curb
Showers To Prop, Linea
Lavatories II To Existing I.
Kitchen Sinks Not Conn.
Dish Washers •SEWER BOXES
Waste Disposals
Wash Trays �� , STORM DRAINAGE
Washing Machines '-nll Size
Water Softeners �_ �r Material
Bar Sinks To Main Drain
Comb. Sink a Trays ��, To Curb
Dental Units
Dnnk_mg Fountainsl, III
Floor Drains WATER SYSTEM
Hoppers �� Size
Restaurant Sinks Material
Sand Traps �� TOTAL FEES
Urinals Fixture Fee
Area Drains �EMain E raih Fee
Water Leaders .,' �� Storm Drain Fee
SP -IIJ'r Va1VC5 Ir Water Sys. Fee
r,�I Permit Fee
TOTAL I� DOTAL FEE
RECORD OF INSPECTION
Partial Rough
Rough Complete ^
Final
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