51006 LOT NO.
NO. EE1'
A ICATI N FOR PLUMBING PERMIT
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CITY OP CUPERTINO
r 0 Sanitary No.
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0 U 'f196— Permit No
i w Pee $ c�
01 cgpf//¢�r�t+ o the City of Cupertino for a permit to install plumbing
' "a Or W.QCtkSi.11ela the reverse side hereof, and agrees to install said prices
> . and/or fixtures in accordance s�1h the provisions of the Plumbing Code of the City of
a w Cupertino, and all other I •s applicable thereto.
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a o St e License Approved
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PLUMBING INSPECTOR
FIXTURES
UNITS FEES UNITSI FEES
Water Heate Size
%X'ater Closets Material
bath Tubs To Curb
Showers To Prop. Line,
Lavatories To Existing
Kitchen Sinks Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
\`('ash Trays STORM DRAINAGE
Washing Machines Size
Water Softeners Material
Bar Sinks To Main Drain
Comb. Sink & Trays To Curb _
Dental Units
Drinking Fountains -
floor Drains WATER SYSTEM
Hoppers Siie
Restaurant Sinks Material
San Traps TOTAL FEES
Urinals Fixture Fee,
iArea Drains Main Drain:Fee
♦X-ater Leaders Storm Drain Fee
Sprinkler Valvcs Mater Sys. Fee
Permit Fee
TOTAL TOTAL FEE
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final .