2590 /G Q 5--0(f
NO. sTREF.T
-FOR -PLUMBING PERMIT
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W Z n/ "�Ci 'r OF CUPERTINO
r o J tFEB 211964 sanitary No.
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Date
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' 0App _ nn Fey'mcreRo theCity b
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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
1- and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
i w Cupertino, and all other laws applicable thereto. iy�e
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r Use of Premises
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o State License— 6 �3 'P•Q C� Approved6�2"'
U PLUMBING INSPECCOR
1X-I URES NUMBER
UNITS FEES UNITS FEES
Water Heate Size
Water Closets Material
Bath Tubs To Curb
Showers To Prop. Line
G,avaturies To Existing
Kitchen Sinks Not Conn.
Dish Washers Sewer Boxes
a;te Disposals
Wash Trays STORM DRAINAGE
Washing Machines Size
Water-Softeners Material
Bar Sinks To Main Drain
Com . Sink a Trays To Curb
Dental Units
Drinking Fountains
rloo QQrains WATER SYSTEM
HoppersSize
Restaurant Sinks Material
San raps TOTAL FEES
rinals Fixture Fee
Tea DDS rains Main Drain Fee
Water Leaders Storm Drain Fee
Sp ler vales n Water Sys. Fee
Permit Fee
T, TA_ L TOTAL FEE e0
RECORD OF IN PECTIO
Underground Rough...
Partial Rough.. i
Rough. Complete..
Nlain Drain
Final...