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2620 LOTNO. y/ NO. z D EP' �R PLUMBING PERMIT r ©P CUPERTINO 196C(maRo Sanitary No. : < o 1 Date Permit No �`ti/ Q� 3 a Wu CII NILF Fee $ D] = o Application is hereby made to the City of Cupertino for a permit install p um mg o < 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 otherlawsapplicable thereto. .a, LL Use of Premises 0 3 Owner / &�j.c�l�� c Address Z J .7C � y�K-CSC//' � a By / Address F CONTRAC'T'OR, AGENT — m Phone -4/.5 - 2 4 2 2— W Z u Y State License elf 15-.7 Approved ao —U n' !� PLUMBING INSPECTOR P I. R : IN BER MAINDRAIN UNITS FEES UNITSI FEES Water Heater 4!-0 jSize Water Closets Materia; Bath Tubs To Curb Showers To Prop. Line Lavatories To Existing Kitchen Sinks Not Conn. Dish Washers Sewer Boxes Waste Disposals Wash Trays STORM DRAINAGE Washing Machines Size 'Water Softeners Material Bar Sinks To Main Drain Comb. Sink s Trays To Curb Dental Units Drinking Fountains Floor Drains WATER SYSTEM Hoppers Size Restaurant Sinks Material San Traps TOTAL FEES Urinals Fixture Fee Area Drains Main Drain Fee Water Leaders Storm Drain Fee Sprinkler Vaives Water Sys. Fee Permit Fee ,� o-o TOTAL TOTAL FEE 7</_ L-Tj RECORD OF INSPECT Underground Rough Partia ough.. -5- .Rough. Complete.. Main Drain Final... 1 .la.