100223 .
LOT NO. 6F
NO. STREET
�C ON FOR PLUMBING PERMIT
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' OF CUPIIRTINO
x g /AUG 1 Sanitary No.
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3 ` Date Permit No /Q ,.23
U Fee $ q d'►
O APTYAWhee ft Ntfity of Cupertino for a permit to install
o a pipes and/or fixtures iT5 ed'th17 verse side hereof, and agrees to install said prices
> and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other laws ajj);LiQa14,,e thereto.
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Use of Premises
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a oState License-�C.�C ,Jt7 Approved .V
U PLUMBING INSPECTOR
FIXTURES NUMBER 11 MAIN DRAIN
Units Fees Units Fees
Water Heater Size
Water Closet Material
Bath Tub LTo Curb
Shower To Prom Line
Lavatories To Existing
Kitchen Sink Not C
Dish Washer
Waste Disposal
Wash Tray STORM DRAINAGE
Washing Machine . 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 Tra TOTAL FEES
Urinal Fixture Fee ...►
Area Drain Main Drain Fee
Water Leader Storm Drain Fee
Sprinkler System Water Sys. Fee
Re]qef Valve.
Vac Breaker
Skimmer
Filter
Pool Sweeper
Permit Fee
Total Total Fee