51009 NO. 5REEI'
FOR PLUMBING PERMIT
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OF CUPERTINO
x n /JUL 18 1906 sanitary �n.
LL
3 Date _ 01,96— Permit No_ s
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CITY OF Fee $
LL � G�
' o Appion is h
licatere yPCity of Cupertino for a permit to install plumbing
`o a 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 Codeof tl e City of
<w Cupertino, and all c r laws .1 1licablio o.
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LL Use of Premises64
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> 0 Owner a +•-a..e Address
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3 } CONTRACTOR, AGENT
— Phone
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State License Approved _
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PLUMBING INSPECTOR
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FIX I URESD BER MAIN DRAIN
UNITS FEES UNITS FEES
Water Heate Size
Water Closets Material
Bath Tubs To Curb
Showers To Prop. Line
Lavatories To Existing
Kitchen Sinks Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
Waslh Trays STORM DRAINAGE
Washing Machines ,/001 Size
Water Softeners Material
•_13ar.Sinks To Main Drain
Com . Sinks Trays To Curb
Dental Units
Drinking Fountains
floor Drains WATER SYSTEM
Hoppers Size
Restaurant Sinks Material
San Traps TOTAL FEES
Urinals I Fixture Fee I Apo
Area Drains Main Drain Fee
Vater Leaders Storm Drain Fee
Jprinldar Valves Water Sys. Fee 00
Permit Fee
TOTAL TOTAL FEE
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final