51145 (2) OC./v 7/ LOT NO, /U O
NO. STREE.I'tl
w ZION FOR PLUMBING PERMIT
OF CUPLRTINO
Y 0 ri
Sanitary No.
0 4
o 19
a 6 Permit
3LL Fee $1,2!�—o
� o
A ++�� or�gyy he !!q µCit}' of Cupertino for a permit to install plumbing
`o a pipe, rldYorlG>ILL 4 e d llil verse side hereof, and agrees to install said prices
> r and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other laws applicable thereto.
a LL Use of Premises
00
> w L
3 Owner Address
Oz_j CROWN PLUMBING CO. IA 6, CAO PLU(l4BING CO. INC.
z By Address F n An: 802
CONT A , AGENT SarafO
3 a Saratoga, �a5'r ,rnia 4o, California
— � Phone
a State License 69 9/0 /2/ Approved Q
ao
—U� PLUMBING INSPECTOR v
FIXTURES
UNITS FEES IV A UNITS FEES
`.'Vater Heate Size'
Water Closets 3 1 Material 0,.T
Bath Tubs To Curb
Showers To Prop. Line
Lavatories 3 To Existing
Kitchen Sinks Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Machines Size
Water Softeners Material
Bar Sinks To Main Drain
Com . Sink u Trays To Curb
Dental Units
Drinking Fountains
Floor Drains WATER SYSTEM
Hoppers Size
Restaurant Sinks Material ggz,
San Traps TOTAL FEES
Urinals Fixture Fee �o ,
Area Drains Main Drain Fee 'j, pU
Water Leaders Storm Drain Fee
Sprinkler Valves Waters.
Fee �r o-D
Permit Fee
TOTAL TOTAL FEE d
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final .