1591 LOT NO. O'
NO. STREET '
r?'JUN
R PLUMBING PERMIT
2 D 1961
1E1
Date 14L Permit No. I� f '
ITY OF CUPERTINO Fees
Application is hereby made to the City of Cupertino for a permit to install plumbing
pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
Cupertino, and all other laws applicable thereto.
y—
Y Use of Premises 3 �2%�/r/y N h 1 L s
a
v
Owner Address
By Add"
CONTRACTOR, AGENT
PhoneF)-, Approv
PLUMBING rNSPE R
UR-ES— UMBER MAIN D RAIN
I UNITS I FEES I IUNITSI FEES
arer Neater I I Size
stet C osets j --Material C,)
'rnth Tubs To Curb
howers To Prop. LineyJ'
,avatories 3 To Existing
titcchen Sinks N on of
9ish Washers I I SEWER BOXEBZ
V ste Disposals
Kash Trays STORM DRAINAGE
Dashing Machines ) Size
u✓�Softeners Material
lar Sinkj To Main Drain
,omb. Sink &Traysl I I To Curb
dental Units
finking Pountains� � �I
door Drains ��_WATER SYSTEM
4oppers
Festaurant Sinks
land Traps TOTAL FEES
lrinals Fixture Fee O —
r� ea Draids Main Drain Fee
Water Leaders Storm Drain Fee
Iprinkler Valves II Water Sys. Fee I D
.rw�� Permit Fee
O AL TOTAL VEE
R COR O CTION
artial Rough
ough Complet
final
Bldg, Dept.
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
[Serr��
wernnection Sanitary Permit No. .............
Plumbing Final Plumbing Permit No.
Lot No. ........s 'I.........
..........
Owner or Tenant ........... ... .. ...
At .............Lo..I...I..,...............
Tract ..................................
............. .... . . ......................
Date Connected ....... ............. -------- ............................ ----<- 19.
Date Final .....................................
19
- ---- .... .
PLUMBING
114S E
111 7/61-500