HomeMy WebLinkAboutNO PERMIT NUMBER cpm I ,C%il LOT NO, 3
NO. STREET
TION FOR PLUMBING PERMIT
z d �•L.� CITY OF CUPERTINO
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NULG 1967 Sanitary No.
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0 ' ate 196_ Permit No
3a
U Pee $
_ °CITYIPOoCUKAT. to the City of Cupertino for a Permit to install plumbing
o r 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
wCupertino, and all other laws applicable thereto.
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.. Use of Premises
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0 3 Owner t / _ Address
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O C NTAACT7 AGENT
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a State License. -31l� ty c) Approved /II
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,1 —U PLUMBING INSPECM.
FIXTURES NUMBER MAIN DRAIN
UNITS FEES UNITS FEES
Water Heater CIO 11 Size
Water Closet Z/1 G. &t Material
Bath Tub 2 3, da '1'o Curb
Shower u _ TD 7'o Prop. Line
Lavatories To Existing
Kitchen Sink L c7O Not Conn.
Dish Washer Sewer Box
Waste Disposal
Wash Tray STORM DRAINAGE
Washing Machine v Size
Water Softener Material
Bar Sink To Main Drain
Comb.Sink&Tray To Curb
Dental Unit
Drinking Fountain
Floor Drain WATER SYSTEM
Hopper Size '
Restaurant Sink Material
Sand Trap TOTAL FEES
Urinal Fixture Fee O.O
Area Drain MainDrain Fee p'D
Water Leader Stonn Drain Fee
Sprinkler Valve Water Sys.Fee Z, —V
Relief Valve Gas Fee U
Vac Breaker
Skimmer
Filter
Permit Fee p'D
Total Total Fee