100028 LOT NO.
NO. STREET
TION FOR PLUMBING PERMIT
OF CUPERTINO L�
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O < Dat nn a 4noa 96— Permit No /0 U
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0 rofPremises heeC� ity of Cupertino for a permit to install plumbing
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o a piurds t - erse side hereof, and agrees to install said prices
r an in acco ore with the provisions of the Plumbing Code of the City of
a w Call other laws applicable thereto.
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ao State License Approved
PLUMBING INSPECTOR
•t- `Y
--FR R 1 BER MAIN
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
Wash Trays STORM DRAINAGE
Washing Machines Size
Water Softeners Material
Bar Sinks To Main Drain
Comb, Sink s Trays To Curb
Dental Units
Drinking Fountains
Floor Drains WATER.SYSTEM
Hoppers Size
Restaurant Sinks Material
San Traps TOTAL FEES
Urinals Fixture Fee'
rea Drains Main Drain Fee «
WX atef Leaders Storm Drain Fee
Sprinkler ValvesWater Sys. Fee
Permit Fee 91
TOTAL TOTAL FEE
RECORD OF INSPECTION
Underground Rough...
Partial Rough..
Rough. Complete..
Main Drain
Final...