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51064 (3)f aF., ClNOr,vad Cr, Lor No. 7'/ o. 0 A D APJFOR PLUMBING PERMIT I JU N 18 1985OF CUPERTINO w � 19D?J Permit No. � Fee $ � Application is hereby made to the City of Cupertino for a permit to install plumbing �Q 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. Use of Premises wne Cr . �. V V 6 S C7. O Address —7 Address 3B //C TRACTOR, AGENT ,r Phone ' V157- VS U _ Approved PLUMBING INSPECTOR FIXTURES NUMBER MAIN DRAIN UNITS I FEES IUNITS FEES Water Heater Size Water Closets Material Bath Tubs To Curb Showers To Prop. Line Lavatories To Existing Kitchen Sinks Not Conn. Dish Washers Waste Disposals Wash Trays I �j STORM DRAINAGE Washing Machines Size Water Softeners Material I Bar Sinks To Main Drain Comb. Sink &Trays To Curb Dental Units Drinking Fountains II Floor Drains WATER SYSTEM Hoppers I Size Restaurant Sinks �� Material Sand Traps TOTAL FEES Urinals Fixture Fee Area Drains I Main Drain Fee Water Leaders Storm Drain Fee Sprinkler Valves I II Wafer Sys. Fee /3= Permit Fee TOTAL TOTAL FEE RECORD OF INSPECTION Partial Rough Rough Complete Final