HomeMy WebLinkAboutNO PERMIT NUMBER (4) LOT NO.
NO. STREET
® F C TON FOR PLUMBING PERM
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° I Date — , 196 6 Permit No
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ILL
' ° liApplicat! ! ion tPjQthe City of Cupertino for a permit to install Plumbing
o a pipes and/or fixtures listed on he reverse side hereof, and agrees to install said prices
> I and/or fixtures in accordance with the provisions of the Plumbing Code of he City of
a w Cupertino, and all other laws applicable thereto. .2097,
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` Use of Premises
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3 3F Owner
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AGENT �'—
— 0 Phone 736` 50 34
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(Too State License Approved
U 'f�3PLUMBING INSPECTOR
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FIXTURES NUI BER MAIN DRAIN
UNITS FEES UNITS FEES
Water Heate Size
Water Closets Material(p,4S
bath Tubs To Cur
Showers To Prop. Line
Lavatories To Existing ✓
Kitchen Sinks Not Conn.
ish Washers Sewer Boxes
Waste Disposals
ash Trays STORM DRAINAGE
Washing Machines Size
Water Softeners Material
Bar Sinks To Main Drain
Comb. Sink s Trays To Curb
Dental Units
Dnn ing Fountains
Moor Drains WATER SYSTEM
Hoppers Size
Restaurant Sinks Material L
San raps TOTAL FEES
Urinals Fixture Fee (z.6-0
rea rains Main Drain Fee
tVater Leaders Storm Drain Fee
Jprinklrr Vales Water Sys. Fee ,p—U
Permit Fee —2.J �o
TOTAL TOTAL FEE 6 : Gt'a
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final