1073 - PLUMBING/a 4z W O LOT
NO. STREET
n FOR PLUMBING PERMIT
1� OF CUPERTINO
MARAV 1%tUo
Date 194Y Permit No. 79
CITY OF CUPERTINO 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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PLUMBING INS]
--T—IXTURES NUMBER MAIN DRAIN
UNITS
FEES
UNITS FEES
Water Heater
Size
Water Closets
Material
- --
Bath .Tubs
To Curb
howers
To Prop. Line
Lavatories
To Existing
Kitchen Sinks_.
Not Conn.
Dish Washers
Waste Disposals
BgyygR 80Jt98
Wash Trays
STORM DRAINAGE
Washing Machines
Size
Water Softeners
�� Material I
Bar Sinks
�� To Main Drain
Comb. Sink .& Trays .t..
�� To Curb
Dental Units
I�
Drinking Fountains
I11
Floor Drains
WATER SYSTEM
Hoppers
Size
Restaurant Sinks
Material
Sand Traps
TOTAL FEES
Urinals Fixture Fee
Area Drains Main Drain
Water Leaders Storm Drah
Sprinkler Vawes Water Sys.
RECORD OF INSPECTION
Partial Rough
Rough Complete
Final
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