2726 (2) v / OT NO.
- no. Q ee
R07F
R PLUMBING PERMIT
f D�MAY 7 1964"
m o cuP>xT1No
Sanitary No.
rc -
0 a Date
3 CITY OF pE 196_
Permit N
w LL Fee$ QQ
To
Application is hereby made to the City 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 N and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
m Cupertino, and a r laws appl' ble thereto.
w Z j
j LL Use of Premis
00
3 Owne - Address
0a
z
J 2 B
J O y CONTRACT AGENT Address
3a '
- Phon _ _ �i ? I
//
ao State License/-/ Approved
—U qPLBING INSPECrTOR
UNITS FEES UNITS FEES
Water Heate _
Size r
�75—
ater C uSets Material N_
Bath"Tubs To Curb
Showers To Prop. Line
Lavatories To Existing
Kitchen Sinks �— Not Conn.
Dish Washers Sewer Boxes
Waste sposas
ps1/iTrays STORM DRAINAGE
Was�g Machines Size
Water Softeners Material
Bar Sinks To Main Drain
Com . Sin s, rays To Curb
Dcntal Units
Drin ing Fountains
I+ oor Drains WATER SY-ffSTEM
oppers Size
Restaurant Sinks Materia
San r�I h TAL FEES
r na s Fixture Fee'
rea rams Main Drain Fee
IU�Leaders Storm Drain Fee
Sprinkler valves Water Sys. Fee
Permit Fee
TOTALeldV TOTAL FEE
RECORD OF I PF.CTI N
I3nderground Rough... — - ,_
Partial 1 Rough.. - t
"Rough. Complete..
Main Drain -
Final...