51231.1 LOT NO. 52
NO. 2.*AL
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VNOR PLUMB PE MI
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F OP CUPF.RTINO
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OTY OF CU
FE'ireye�r Sanitary No,
0 < Date _7 '/ 19�� Permit No
=LL JUN 8 1971 Pee S.23
O Application is hreby made to the City of Cupertino for a permit to install plumbing
o a pipesfi>�ulisted on the reverse side hereof, and agrees to install said prices
i m` and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other la pplicab e thereto.
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oState License �ly0 Approo d
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LUM[iING INSPECTOR A
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FIXTURES NUMBER MAIN DRAIN
Units Fees Units Fees
Water Heater 4�rvll Size
Water Closet j,CO I Material
Bath Tub triQ I To Curb
Shower To Pro . Line
_Lavatories 3,CD I To Existin
Kitchen Sink Not Conn
Dish Washer
Waste Dis osal
Wash Tra STORM DRAINAGE
Washin Machine ,JO Size
Water Softener I Material
Bar Sink To Main Drain
Comb.Sink&Tray To Curb
Dental Unit
Drinking Fountain
Floor Drain WATER SYSTEM
Hopper Size's
Restaurant Sink Material
Sand Trap TOTAL FEES
Urinal 11 Fixture Fee V
Area Drain Main Drain Fee 00
Water Leader Storm Drain Fee
Sprinkler System Water Sys. Fee S
Relqef Valve, 11 Qnq Fee
50
Vac Breaker
Skimmer
Filter
Pool Sweeper
Permit Fee
Total 64Total Fee . 5 a