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APrlt' N��,IFOR PLUMBING PERMIT
a �S! OP CUPERTINO
w = 1FEB 28 1964
r o Sanitary No.
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3 a Date '✓� �•;496— Permit Noi�el l3'
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� Application is hereby made to the City 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
r and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other ws applicable t�
LL Use of Pre s fit
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� 3 Owner Address
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CONTR CTOA,AGENT
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a LL State License� prove Lt� W.:i-lZazteAp
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/y—�]U PLOMBING INSPECTOR
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-I�IX 1i
UNITS FEES UNITS FEES
`.Vater Heate Size
Water Closets Material
Bath Tubs To Curb
Showers To Prop. Line
Lavatories To Existing
KitFhen Sinks Not Conn,
Dish Washers Sewer Boxes
Waste Disposals
Wadi Trays STORM DRAINAGE
Washing Machines Size
Water Softeners Material
Bar Sinks To Main Drain
Com . Sink-&Trays To Curb
Dental Units
Drinking Fountains
Floor Drains WATER SYSTEM
Hoppers Size
Restaurant Sinks Material
San Traps TOTAL FEES
Urinals Fixture Fee ,p
Area Drains OO Main Drain Fee
Water Leaders Storm Drain Fee
Sprinkler Valves Water Sys. Fee
Permit Fee
TOTAL TOTA FEE a
RECW F I SPE BION
Underground Rough...
Partial Rough.. l
Rough. Complete..
Main Drain �
Final... xO Lam/
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