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LOT NO. —:?S—
NO.
PLUMBING PERMIT
UPERTINO
(FEB 27 1988 Sanitary No.
Uate 196_ Permit No
T �� O(� Dp[[''pp II�� Fee �.�•`��
Applicatiol lis herQ y� mY�4o4h�ldAy'Of Cupertino for a permit to install plumbing
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
Owner
.�• /- •�•
Owner ' (
By C9 .
CONTRA - R, AGENT
Phone %l`IS-� 60
State License �• 30 �5�2
Address
c,
Address 6 a 7
Approved &/� < /
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PLUMBING INSPECTOR /
FIXTURES NUMBER VAIN DRAIN
UNITS FEES UNITS FEES
Water Heater / s Size °o
Water Closet
d.
3.00
Material
Bath Tub
Z
—7—F
I / sd
To Curb
Shower
Dental Unit
/'s�
To Prop. Line
Lavatories
-2.00
'Po Existing
Kitchen ink
/
.3'0
Not Coan.
Dish Washer
-o—
Sewer Box
Waste Disposal
-
TOTAL FEES
Wash Tray
Urinal
Fixture Fee
STORM DRAINAGE
Washing Machine
Main Drain Fee
SU
Size
Water Softener
Material
Bar Sink
To Main Drain
Comb.Sink & Tray
To Curb
Dental Unit
Drinking Fountain
Floor Drain
WATER SYSTEM
Hopper
Size
Restaurant Sink
Material
Sand 'Trap
TOTAL FEES
Urinal
Fixture Fee
SD
Area Drain
Main Drain Fee
oe
Water Leader
Storm Drain Fee
Sprinkler Valve
Water Sys. Fee
S -Z
Relief Valve
Gas Fee
so
Vac Breaker
Skimmer
Filter
Permit Fee c
Total ,C3.S0 'Total Fee �3 Sa