51145 PLUMBING ztall • LOT NO. 199
NO, STNEP'
APPLI ION FOR PLUMBING PERMIT
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0 � Date AP [All')6— Permit
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� �} hqr�� h b� made to the City of Cupertino for a permit to install plumbing
o 1 pip , nl�/okJfixtu � a� rif tin reverse side hereof, and agrees to install said prices
> 1 and/or fixtures in acco l Vifothe provisions of the Plumbing Code of the City of
wCupertino, and it[ o 'r laws �licable thereto.
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rc a u sState License 7 Approved
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— 0 / PLUMBING INSPECTOR
FIXTURES D
UNITS FEES UNITSI FEES
Water Hcatc Size dl I
Water Closets Material C,Z
Fath Tubs To Curb
Showers To Prop. Line
Lavatories To Existing
Kitchen Sinks Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
\tt ash Trays STORM DRAINAGE
Washing Machines Size
Water Softeners Material
Bar Sinks To Main Drain
Com . Sink s Trays To Curb
Dental Units
Drinking Fountains
Floor Drains WATER SYSTEM
Hoppers Size
Restaurant Sinks Material AL
Sand Traps TOTAL FEES
Urinals Fixture Fee
Area Drains Main Drain Fee 7
�t--ater Leaders Storm Drain Fee
�prinklrr Valvcs Water Sys. Fee
Permit Fee
TOTAL TOTAL FEE CO
RICORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final