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APPLICATION
SEP 19 1966 CITY
LOT
0
FOR PLUMBING PERMIT
OF CUPERTINO
pat' ,i — A,6 � Permit No.
J—// c� /
..ii
f L IIUnII� T Fee $ ��l�. C
77
Application is hereby made to the City 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
'1-7338
Address
Address
Approve d�
PLU 4EING INSPECTOR
IX�L R Es
NUMBER
MAIN DRAIN
UNITS I FEES
IUNITS I FEES
Water Heater 1
1.9,901
Size ,AU
Water Closets
jo.00ll
Material C, I I
Bath Tubs
Ie2,00
II To Curb
Showers
/ J,OO
To Prop. Linet�
Lavatories
_ 3,00
To Existing
Kitchen Sinks
I,2.D0I
Not Conn.
Dish Washers
Waste Disposals
Wash Trays
STORM DRAINAGE
Washing Machines
z -7. OE)
11 Size c4)
9—
Water Softeners
Material
Bar Sinks
To Main Drain
Comb. Sink & Traysl
I
I To Curb
Dental Units 1
Drinking Fountains)
III
II
Floor Drains
WATER SYSTEM
Hoppers
Size //
Restaurant Sinks
II Material C,41V I I
Sand Traps
TOTAL FEES
Urinals
Fixture Fee S-
Area Drains
Main Drain Fee ��
Water Leaders
Storm Drain Fee
Sprinkler Valves I
I Water Sys. Fee 6-0
I� Permit Fee a _Q
TOTAL
TOTAL FEE a
RECORD OF INSPECTION