1982 (2) LOT NO. /
/ APPLINTIO R PLUMBING PERMIT
W i TAR 5 ' .Wl CUPERTINO
' o Sanitary No.
3u Date �U�lw Permit No 7/
= LL Fee$_o _
c o Application is hereby made to the City of Cupertino for a permit to install plumbing
O pipes and/or fixtures listed on the reverse side hereof, and agrees to install said rices
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an fixtures in attordance with the provisions of the Plumbing Code of the City of
z m Cupertino, and allher laws applicable thereto . 'L
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License ���� 7/ APP
- PLUMBING WSPE
-T-TXTURTT_ NU BER I MAIN DRAIN
UNITS FEES UNITSI FEES
Nater Heater pMateri.al
Ater C oSetS ial
Fath Tubs
ihowers rop. Line
avatories isting
Utc en Sin onn. _
Is Was ers /_
-ewer Boxes
waste Disposals
wush Trnys ORM D A GE
as ing Machines
KIWer Softeners ial
3%r Sinks ain Drainom . , in raysurb
7nta Units
nn m' Fountains
ogr Drains WATER SYSTEM
oppers ,1 Size
estaurant Sinks Material
Sand raps TOTAL FEES
Minas Fixture Fee
rca rams Main Drain 1'ee G
Water Leaders Storm Drain Fee
Watesprinkler Vnives Permit FSye. Fee
Permiee
OTAL TOTAL FEE
RECORD OF INSPECTION
Underground Rough,. —/Y_3
.Partial Rough..
.Rough: Complete –
i'iain Drain
Final—
T 9
8 � y
v, 6
W ; , :off
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tai�0 m