860 T.- i¢'✓'aLi•F'- -.�.' nom. -.- , :r..-.�-v -�.J' / :. ..
LOT No.-
Ro.k. STREET '
a „A1jfAPPtiLIC/1XION FOR PLUMBING PERMIT.
^� CITY OF.CUPERTINO
Date'"11. ,I P. CIIPERTINO195_ Permit No. ^
QU—
Fee je�
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
:t a
Owner /�/9<// �� Address
B Addre
DoE AMS �,
'P6one -goo THE ALAMEDA - ApproCALWv
i
6ANTA CLARA• K-7I PLUMBING INSPECTOR
•IX URES NUMBER MAIN DRAIN
'UNITS 'FEES IUNITSI FEES
;Water Heater _ Size
�Water aterial -
Bath Tubs •: II .To,Curb
Showers .j �it 11 To'Prop. Line
'tLavatohes 121, I. • i jI •To•Existing
.Kitchen Sinks
Dish Washers 671
Waste Disposals
Wash Trays II STORM DRAINAGE
Washing Machines I II Size {
!Water Softeners Material I
Bar SinksTo Main Drain r
Comb. Sink s Trays To Curb
Dental Units
Di-inking.Fountains � II
Floor Drains 11 WATER SYSTEM
Hoppers II Size
Restaurant Sinks Material r
Sand Traps TOTAL EES
Urinals Fixture Fee
Area Drains Main Drain Fee I/
Water Leaders Storm Drain Fee
Sprinkler Vntves I I II Water Sys. Fee V
JW
Permit Fee 09-
TOTAL SII TOTAL FEE
RE ORD OF SP TION
Partial Rough, ,Q _
Roug Complet
Final
Cupertino Sanitary
Office Copy:.
" BUILDING INSPECTOR'S'OFFICE
CITY,OF CUPERTINO
F-1 Sewer Connection Sanitary Permit No 4k.-; .. /
[w]''Plumbing Final - - Plumbing Permit No. ._�/�6-. - -----.-
d Lot W. -
Owner or Tenant iA .. -- - - 9~s- ----....
At
- ...........
Tract ... .� ---------- --_ .. _....._... .._.....---- -------------------
-
(y
Date Connected ......--- ..... ......
......dr`........................................
19 �.
7,
Date Final --------....................-------- r _ .. 19*,./
.. ..:---- ---------
MBING INSPECTOR,
111 ,1/60-500 _ - -