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51089.2 LOT NO. NO. STREET APPLICATION FOR PLUMBING PERMIT d CITY OF CUPERTINO z = 3'793 w x o �j Sanitary No. 3 ate 14 1968 Permit No. S/0917• oZ/ Fee S 1 Application .:h ley ide to the City of Cupertino for a permit to install plumbing o a, �,ps and; fixturei&Pg( on the reverse side hereof, and agrees to install said prices andyor-f Xt �in ah ce with the provisions of the Plumbing Code of the City of Zm Cupertino, and allMlaws applicable thereto. L. 00 3 Ownerk Address / f Oz By�:l .�t / U/l�Y[ca ©( S. Address n CONTRA CTOR, AGENT 3 � � 2S3A — z Phone w z I to State License Approved U PLUMBING INSPECTOR. FIXTURES NUMBER MAIN DRAIN UNITS I FEES11 UNITS FEES Water Heater Size q Water Closet 0011 Material e- Bath Tub To Curb Shower '('a Prop. Line Lavatories gp To Existin Kitchen §ink Not Conn. Dish Washer Sewer Box Waste Disposal .00 Wash Tray STORM DRAINAGE Washing Machine Size Water Softener Material Bar Sink 'I'o Main Drain Comb.Sink&Tray To Curb Dental Unit Drinkin Fountain Floor ikain WATtFR SYSTEM Hopper - Siz Restaurant Sink Materia Sand Trap TOTAL FEES Urinal Fixture Fee Area Drain Main Drain Fee Water Leader Storm Drain Fee Sprinkler Valve Water Sys.Fee Relief Valve Gas Fee 'd Vac Breaker Skimmer Filter . 5 Permit Fee Total 'Total Fee 3. Sp