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APPLICATION FOR PLUMBING PERMIT
13/
0 CI F C( PERTINO
Sanitary No.
Date t300" ''� Permit No Sj���
ree §l—?"5
Application is hereby made to th
pipes and/or ficgr;mjlis(dTor> 'I
and/or fixtures -n hccor ��ce wi
Cupertino, and all,(e-511.1ws appl
Use of
State Isi9y
rtino for a permit to install plumbing
reof, and agrees to install said prices
of the Plumbing Code of the City of
V
Approved C::L'_I r.: 7 .
PLUMBING INSPECTOR
_ FIXTURES NUMBER MAIN DRAIN
UNITS I FEES UNITS I FEES
Water Closet
To ProD. Line
Kitchen link �� Not Conn. I
Dish Washer Sewer Box
ze
Comb.Sink & Tray I 1 11 To Curb
Floor Drain
WATER SYSTEM
Hopper
Size
Restaurant Sink
Material
Sand Trap
TOTAL FEES
Urinal
Fixture Fee
Area Drain
Hain Drain Fee
Water Leader
Stom Drain Fee
Sprinkler Valve
Water Sys. Fee
Relief Valve
Vac Breaker