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51114 /C Y / C �^-^-"-'�� LOT NO. NO. l' PP TION FOR PLUMBING _PERMIT CITY OF CUPERTINO z i s w\O Sanitary No. 19� Y 1� R ` ' Z� Permit No w LL \ C Fee $ �. o so AVca© is hereby made to the City of Cupertino.(or a permit to install plumbing o W pi d/or,fixtures listed on the reverse side hereof, and agrees to install said prices > an r.hxtures in accordance with the provisions of the Plumbing Code of the City of a m Cupertino, and all other laws applicable thereto. 0 o Use of Premises 3 Owner !- �1-�Liy Address /c'/zi ozJ ,y�7 ^p z By,�/� t� _—'' -14 t.-.��rr .-tee- Address a7/ O � f ,CONTRACTOR, AGENT 3 h - m Phone— 3 70 ' w z A roved ri::-L:?.:.: ;J. --P:^✓!CQ-{ a a State License pp -U PLUMBING INSPECTOR FIXTURES NUMBER 11 MAIN DRAIN UNITSI FEES 11 UNITS FEES Water Ileater Size Water Closet Material Bath Tub '1'o Curb Shower To Prop. Line Lavatories To Existing Kitchen Sink Not Conn. Dish Washer Sewer Box Waste Disposal Wash Tray STORM DRAINAGE Washing Machine Size Water Softener Material Bar Sink To Main Drain Comb.SinkBTray To Curb Dental Unit Drinking Fountain Floor Drain WATER SYSTEM Hopper Size Restaurant Sink Material Sand Trap TOTAL FEES Urinal Fixture Fee Area Drain Main Drain Fee Water Leader Storm Drain Fee Sprinkler Valve Waters s.Fee Relief Valve Gas Fee Vac Breaker Skimmer Filter Permit Fee Total Total Fee