51046 p 6 '1- 71 4\ LOT NO.
NO. STREET
,�4P�LITION FOR PLUMBING PERMIT
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34 Pee $ 7 0 0
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A nio n hq�'�g❑ tp� e Cit of Cupertino fora permit to install plumbing
`o PiPtlancr/orl.fiCturF~S�R.�tdJlb�l ldi everse side hereof, and arees to install sid Prics
> and/or fixtures in accordance with the Provisions of the Plumbing Code of the City of
wCupertino, and all other laws applicable thereto.
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-U PLUMBING INSPECTOR ��
FIXTURES NUMBER MAIN DRAIN
UNITS FFEES UNITS FEES
Water Heater Size
Water Closet Material
Bath Tub To Curb
Shower To Prop. Line
Lavatories To Existing
Kitchen Sink Not Conn.
Dish Washer Sewer Box
Waste Disposal
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
Area Drain Main Drain Fee —
Water Leader Storm Drain Fee
Sprinkler Valve Water Sys.Fee
Relief Valve Gas Fee
Vac Breaker
Skimmer
Filter
Permit Fee
Total Total Fee '70e