51073 (2) Z k O 3 Ill��1CCLeJ LOT NO. 7/
NO. STREET 1
APPLICATION FOR PLUMBING PERMIT
< i CITY OF CUPERTINO
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' 0 r.. n 09 Sanitary 1u.
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< Date J--/�C 19f8 Permit No � 7J
w� Fee $ 0
' 0 Application is hereby made to the City of Cupertino for a permit to install plumbing
`o pipes and/or fixtures fisted 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 N Cupertino, and all other laws applicable thereto.
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< Use of Premises
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f State License Approved
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U PLU7ING INSPECTOR v
FIXTURES NUMBER MAIN DRAIN
UNITS FEES UNITS FEES
Water HeaterSize
Water Closet `((j Material
Bath Tub .? To Curb
Shower To Prop. Line
Lavatories To Existing
Kitchen Sink Not Conn.
Dish Washer 3 Sewer Box
Waste Disposal 3
Wash Tray STORM DRAINAGE
Washing Machine Size
Water Softener Material
Bar Sink To Main Drain
Comb.Sink&Tray To Curb
Dental Unit
Drinking Fountain
Floor Drain WATER SYSTEM
Hopper Size
Restaurant Sink Material
Sand Trap TOTAL FEES
Urinal Fixture Fee —3 %•6 0
Area Drain Main Drain Fee w
Water Leader Storm Drain Fee
Sprinkler Valve Water Sys.Fee
Relief Valve Gas Fee .521
Vac Breaker
Skimmer
Filter
Permit Fee ov
Total 'L z'• Total Fee �`7)