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620 PLUMBING PERMIT41 /s r tet' C^— LOT NO. STREET _ APPLICATION FOR PLUMBING PERMIT ITY OF CUPERTINO e — l ly 1 Permit No. ISM ;W;-1WS Fee $ Alic�'f{�n i'�'R�I� the City of Cupertino for a permit to install plumbing andJor fixtures Iste 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. Use of Owner By_ CONTRACTOR, AGENT v Address ©.T" -1 S7 ,1&, -a n7 R / %a D Address Approve PLUMBING INSPECTOR I UNITS I FEES II 1 UNITS I FEES Water Heater I I 11 Size Water- closets I I II material I I Bath Tubs To Curb Showers To Prop. Line Lavatories To Existing Kitchen Sinks I II Not Conn. Dish Washers I� Waste Disposals Wash Trays STORM DRAINAGE Washing Machines I I Size Water Softeners Material Bar Sinks To Main Drain Comb. Sink & Trays II To Curb Dental Units Drinking Fountains I Floor Drains �� WATER SYSTEM Hoppers I I II Size Area Drains I II Main Drain Fee Water Leaders Storm Drain Fee Sprinkler Vaives I I II Water Sys. Fee I I Permit Fee I AL RECORD OF INSPECTION