NO PERMIT NUMBER (9) ADDIT.TONZ PERMIT FEES
BUILDING PROJECT IDENTIFICATION VALUATION
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C'1/ EC iN0 C / j PLAN CHECK
Doe TRACTDR s FEE
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FE oxE S- 000 SEISMIC FEE
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OTY. ELECTRIC PERMIT FEE
UTLETS-SWITCHES-RECEP lr ELECTRIC l 7 OV
LIGHTING FIXTURES
PLUMBING
APPLIANCES RESIDENTIAL
PANELS MECHANICAL
SIGNS
SIGNS TRANS. TOTAL'
SPECIAL CIRCUIT
EMP.METER OR POLE INS. PERMIT VALIDATION
MOTORS SEE FEE SCH.
SERVICE CHANGE
Z z
F ° TOTAL ,7
Q — ISSUANCE DATE
LU > OTY. PLUMBING PERMIT FEE BLDc, ELECT, PLO MECH.
CL 0
D z ALTER-DRAIN&VENT-WATER (EA.) o
U O BACK FLOW PROTECT.DEVICE
O w DRAINS FLOOR,ROOF,AREA,COND.
>. d FIXTURES-PER TRAP
N
Z GAS-EA.SYSTEM-I INC.4 OUTLETS
() GAS-EA.SYSTEM-OVER 41EA.1
INDUSTRIAL WASTE INTER.
LAWN SPRINKLERS-1 INC 5 V.B.
LAWN SPRINKLERS-OVER 51EA.)
SEWER-SANITARY-STORM EA.200,ft/
WATER HEATER W/VENT
WATER SYSTEM
WATER TREATING EQUIP.
TOTAL
OTY. MECHANICAL PERMIT FEE
ALTER OR ADD TO MECH.
APPLIANCE
AIR HANDLING UNIT ITO 1QMOCEM)
AIR HANDLING UNIT(OVER 10=C.F.U)
EXHAUST HOOD(WITH DUCT) T
HEATING UNIT(TO 100,000 B.T.U.)
HEATING UNIT(OVER 100,000 B.T.U.)
VENTILATION FAN(SINGLE)
BOILER-CU.P(OH.P.Dr1000OOB.T.U.)
BOILER COMP(0-1 100,000 BTU)SEE FEE SCH.
'� TOTAL
CITY OF CUPERTINO P.G.B E.
COPY
GAS SERVICE NOTICE
To
You are hereby authorized to connect the GAS service for
Owner or Teno
At
New Service—
No.
ervice No. of Meters Reconnect
No. of Add. Meters Move Service
Move Meter
PLUMBING INSPECTOR
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