51046 (3)r /O�S/ SI /IIJd� D// `•/ LOT NO.
NO. STRF.F-I
,AP, L TION FOR PLUMBING PERMIT
� � � Y OF CUPERTINO
w z "✓
r o Sanitary No.
R LL INOV 2 ' o Z
0 Date ,; 96 Permit No.
W LL Fee S3•
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J,}IU is hrrrb}�m e City of Cupertino for a permit to install plumbing
o pips 9nd/o}7xtuff1 lSsledSrlrlthreverse 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.
Use of Premises 17a/LG
00
3 Owner �i��sr �/�Tt's2- Address ��bs7�
By RAYNE SOFT WATER SERV"tdress
3 0 CONTR.I[jC)R;IAGEN'N0.
— m Phone SANTA CLARA, CALIFORt1tA 95050
w w PHONE 241-3370 VVILLIAM D.
p a `�3�4LS Approved
a o State License
�\ -U PLUMBING INSPECTOR —
FIXTURES NUMBER MAIN DRAIN
UNITS FEES 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 R 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