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qpL ION FOR PLUMBING PERMIT
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196— Permit No
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� ahon is hereby made to the City of Cupertino for a permit t0 install plumbing
`o a pi( y nd/or fixtures listed on the reverse side hereof, nd ees to install said prices
> and/or fixtur n ,ccordance with the provisions of the m ing Code of the City of
a w Cupertino, an all other laws applicable e o.
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FIXTURES NUMBER MAIN DRAIN
Units Fees Units Fees
Water Heater Size
Water Closet Material
Bath Tub To Curb
Shower !
o Pro D. Line
_Lavatories To Existin
Itchen Sink Not Conn,
Dish Washer
Waste Dis osal
Wash Tra STORM DRAINAGE
Washin 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 Trap TOTAL FEES
Urinal Fixture Fee
Area Drain Main Drain Fee
Water Leader Storm Drain Fee
Sprinkler System Water Sys.Fee
Vac Breaker
Skimmer
Filter
Pool Sweeper
Per it Fee
Total Total Fee