866 LOT NO. ✓ ,
NO. Q • EN
�® - A PA N FOR PLUMBING PERMIT
,i AUGo 12 1960 TY OF CUPERTINO
t 195_ Permit No.
Fee $
`i 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.
=Use,of,Premises
N� :a
Owne
BylOE AMARALVLUMBING, INC'CONT /Address
'Y ; Phone SANTA TEMP , CRYRNIA Approve
4l
' PLUMBING INSPECTOR
__F1XiURES NUMBER MAIN DRAIN
ri UNITS FEES 11 UNITS FEES
Size j
Water Heater
Water Closets j j fijj Material j
Bath Tubs; / To Curb
Showers ,f �� To Prop. Line
Laies vatorTo Existing
Kitchen Sinks �� Not Con : S
Dish Washers
,Waste Disposals � .
Wash Trays , I 1 11 STORM DRAINAGE
Washing Machines j Size j
Water Softeners Material
Bar Sinks j j p To Main Drain j
Comb. Sink a Traysl To Curb j
Dental Units I
Drinking Fountainsl I iI,
Floor Drains WATER SYSTEM
Hoppers Size
CIE Restaurant Sinks �� Materia
Sand Traps TOTAL TIEES
Urinals Fixture Fee j
Area Drains , . j Main Drain Fee j�
Water Leaders j j jj Storm Drain Fee j
Sprinkler Valvesj jj Water $y5. Fee
j j _ A Permit Fee (�
TOTAL TOTAL FEE / �—
��
RECORD OF�INSPECTION
Partial Rough 1 ")
Ron Jh gmplete
Final �/o%
Cupertino,Sanitary
(*cc j+PY
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO /
' Sewer Connection
Sanitary Permit No. .....! �
_ Y -------/--- -----------
(7O'Plumbing Final Plumbing Permit No. ..... ------
.� Lot No. -T�' .;--/p.. ----------- '
Owner or Tenantell ..............
At - --- I
Tract ......-'---- --<`- �-C .. a�.--- -
DateConnected .....-- /..._./.. . .. .. ........-----_..----- ---------------------- 19..(c241
Date Final ----------" --.07 ......:....... �j/
._............------- 19_.......:
....... .. ...... ..�....s.....................
u 1/60-500 PLUMBING INSPECTOR