2600 -LOT NO.
NO. STREET
® FOR PLUMBING PERMIT
d C OE CUPERTINO
>! o �,� 'f EB 2 8 1964 Sanitary No.
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o a Date �/ '>'n 19G�' Permit No C��/' 6'0.
W ((�� ((�� IIpp[[Dp'[[ G,U
' 0 Apph'K,QFheX15yrtn�dbttb:the City of Cupertino for a permit to nstal� I plumbing
`o a pipes and/or fixtures listed 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 w Cupertino, and all other laws applicable thereto.
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a ~ Use of Pre ises "'t-'/ -��r-�
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CONTRACTOR,AGENT
; m Phonn
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a o State License Approved
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p ( PLUMBING INSPECTOR
FIXTURES NUMBERIDRAIN
UNITS FEES UNITS FEES
Size
Water Heater � /A'7/ '4
Water Closets 'vr� Materia'_ 0)
Bath Tubs -z To Curb
Showers Is-4 To Prop. Line
Lavatories a o-V To Existing
Kitchen Sinks j �, Not Conn.
Dish Washers Sewer Boxes „�U'"U
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Machines Size
'.eater Softeners Material
Bar Sinks To Main Drain
Comb. Sink % Trays To Curb
Dental Units
Drinking Fountains
Floor Drains WATER SYSTEM
Hoppers Size "
Restaurant Sinks Material 0.4
San Traps TOTAL FEES
Urinals Fixture Fee
Area Drains Main Drain Fee
\eater Leaders Storm Drain Fee
Sprinkler Vaivcs Water Sys. Fee
Permit Fee ,? o-V
TOTAL o q TOTAL FEE
RECORD OF INSPECT—!94,
Underground Rough... _
.Partial nugh.. -
Rough. Complete.. —,3p —
.Main Drain
Final._ i
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