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NO. STREET
LIGATION FOR PLUMBING PERMIT
z a CITY OF CUPERTINO
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x O Sanitary No.
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o a 196 7d Permit No 6
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AV>� one
y made to the City of Cupertino for a permit to install plumbing
'and/or sted on the reverse side hereof, and agrees to install said prices
d/or fixyurrdance with the provisions of the Plumbing Code of the City of
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upertin( d all other laws applicable thereto.
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j a Us�?o6 Premises
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3 Owner ,Pi lLZTI- Address lb 6a7 S. ZZm,
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� z Byte � P�u�.,R,.. r ,S�,c -, - ddress 396 l�o,e,2,in,ow Z-
3 � CON"1'R-eQ�R, AGENT
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a 2 State License a 332yD Y Approved
PLUMBING INSPECTOR
FIXTURES NUMBER ' 11 MAIN DRAIN
Units Fees 11 Units Fees
Water Heater Size
Water Closet Material
Bath Tub To Curb
Shower To Prop. Line
Lavatories To Existing
Kitchen 'n Not Conn.
Dish Washer
Waste Disposal
Wash Tray STORM DRAINAGE
Washing Machine Size
Water Softener Material
Bar Sink To Main Drain
Comb.Sink&Tray To Curb
Dental Unit
Drinking Fountain
Floor Drain WATER SYSTEM
Hopper Size
Restaurant Sink Material
Sand Trap TOTAL FEES
Urinal Fixture Fee j
Area Drain Main Drain Fee
Water Leader Storm Drain Fee
Sprinkler System Water Sys. Fee
Relief Valve, 11 Gnq Fee,
Vac Breaker
Skimmer ( _
Filter
Pool Sweeper
Permit Fee o 0
Total Total Fee . �'