51145 Plumbing Permit LOT NO.
NO. STR EF.i'
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�J�PFOR PLUMBING PERMIT
TY OP CUP[RTI[VO
xo 22 1966 't� sanitary No.
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Oa 1 196— Permit No.
3 LL CITY OFQJPERTIP (� Fee s�lG °'
o Application is hereby made t�Yhe City of Cupertino for a permit to install plumbing
'o a 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
a w Cupertino, and all other laws applicable thereto.
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LL Use of Premises
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3 Owner Address
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o f State License Z � `"� � � Approved
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U/I PLUMBING INSPECTOR
IAX I URESNUMBER
UNITS FEES UNITS FEES
Water Heate Size at
Water Closes Material C.L
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
Com . Sinks Trays To Curb
Dental Units
Drinking Fountains
Floor Drains WATER SYSTEM
Hoppers Size
Restaurant Sinks Materia(
San Traps TOTAL FEES
Urinals Fixture Fee
Area Drains Main Drain Pee
Water Leaders Storm Drain Fee
prink ler valves Water Sys. Fee
Permit Fee
TOTAL TOTALFEE
RE ORD F INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Hain Drain
Final