831 OS 74 1 oti (J(�] {/Ij
`• � �_`��`^� LOT NO.
4 NO. STREET
V �APPLI'ChATIOFOR PLUMBING PERMIT
jCITY OF CUPERTINO
JU�12196g.
Date L 1940 Permit No.rb
l
PERTINO
ITY OF CUFee$ 's-
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
V and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
Cupertino, and all other laws applicable thereto.
d O
Y, Use of Premises
a
W
Owner > 0 Address Q 6-c
Address J . .
CON`cRAETOR, ALEN,7�/ ✓
Phone �— ef V ' _ Approved
__ PLUMBING INSPECTOR A
NUMBER e-,MAIN tD�Rt, Lq,
rUNITS I FEES 11
�Hcaler al"
C ebmami
Material
�IWVOIVM MS
To C
6,Showe sTj,?j, To Prop. Lirie-7rL
Lavatories To Existing
Kitchen Sinks Not Conn.
Dish Washers 'SEWER B0XE!jj
Waste Disposals
Wash,Tmys. STORM 5DRAII . A(jE
wWashing"Machines
.or Size
SW,aker;S%teners
In Main Drain I- I
r,'CombMSi?!k?s Trays To Carb—
i
Dental Units
�-D
� Floor Drains ` jj WATER SYSTEM
LHoppers Size
' Restaurant Sinks Material
I Sand Traps TOTA,L.FEES
Urinals' l I li, 'Fixture Fee MY
Area Drains Main Drain Hdjj!,0
Water Leaders Storm DrainTiBOW.
Sprinkler Viives 41, Water Sys. FYZJ�?-W
Permit Fee
TOTAL OTAL FEE 4W*tr,
RECORD OF INSPECTION
.Partial Rough
Rouglf Complete
Final -772-V56