1354 /O / OO I V\_Q ` ' i "'_'�`� I�./ i 4 LOT NO.
No. STREET
'
PI! ON FOR PLUMBING PERMIT
Aopr{� OF CUPERTINO
Date $ 191 Permit No. 7-
�I� .OF C.e ffRTINO Fee
pp I tion is here y 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
Q and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
Cupertino, and all other laws applicable thereto.
Use of Premises
:a 1_
y 'o Q— *WliPECT
Owne Q.d d.. Address 7��By�� AddressON CTO , AGEPhone� APProvePLUMBING
I
FIXTURES NUMBER MAIN DR IN--
UNITS FEES I IUNITSf.'FEE
Water Heater i Size
Water Closets Material
Bath Tubs To Curb
Showers To Prop. Line I:s
Lavatoriesj To Existing t,q
Kitchen Sinks Not Conn.
Dish Washers
Waste Disposals
\\ash Traysi STORM DRAINAGE
Washing Machines I I II Size I I
Water Softeners Material I
Bar Sinks l �� To Main Drain
Comb. Sink s Traysl II To Curb - I — �_
ffe—nt.,I Units 11
Drinking Fountains) � II
Floor Drains 11WS'ATER SYSTEM
Hoppers I Size �—
Restaurant Sinks II Material
Sand Traps TOTAL FEES
Urinals Fixture FeesL
Area Drains Main Drain Fee I I
Water Leaders II Storm Drain Fee-1 ;,M
Sprinkler Varves Water Sys. Fee
Permit Fee �
TOTAL V/ 7( TOTAL FEE T
RECORD OF INSPECTION
Partial Rough 4
Rough Complete L
Final