51075.1 OVE7/ 12t - al AUP LOT NO.
NO. STREE
(lNr� A, ��qT N FOR PLUMBING PERMIT
`_ I P CUPERTINO
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x o Sanitary \0. G/ 7"
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3 a [)are Permit No. 107,S71
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Fee $ �,;- �t—o
0 All7c�q i,.({erre� [9 p t of Cupertino fora permit to install plumbing
o a pipes ahth/b� Gatti�cs IS NIER11e1}�j�se side hereof, and arees to install sid rice
> . 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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LL Use of Premises
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3 Owner Address
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3 CONTRACTOR, AGENT
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a o State License 2 7/Z71
Approved
PLUMBING INSPECTOR
[N-' K
FIXTURES NUN BFR MAIN DRAIN
UNITS FEES UNITS FEES
`dVater Hcatc Size
�Y'ater C oscts Material
bath Tubs To
Showers To Prop. Line
Lavatories 3 To Existing
Kitchen Sinks Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
ash—Trays-- STORM DRAINAGE
UUas ing Machines Size
Water &afteners Material
Bar Sin Fs To Main Drain
Comb. Sink u Trays To Curb
Dental Units
Drin ing Fountainsj j
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P oor Drains ATER.SYSTEM
HoppersSize
Restaurant Sinks Material
an raps TOTAL FEES
rinals Fixture Fee apo
Area Drains Main Drain Fee
mater Leaders — Storm Drain Fee
Sprinkler Valves W Sys. Fee
Permit Fee
TOTAL Uu TOTAL FEE w
RECO OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final