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NO. STREET
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PLUMBING PERMIT
D CITY �CUPERTINO
i4psY��s11062 .
Date 195_ Permit No.
`CITY-.1OF CUPERTINO Fee_$
Application,is hereby made to 41ic City`of,Cupertino for a per to install plumbing
•pipes and/or fixtures listed on tbeJk'verse side hereof, and agrees to install said prices
and/or fixtures in accordance with'* provisions of the Plumbing.Code of the City of
Cupertino, and all other laws'applicable•thereto.
8 d:USC of Premises'
v AV
t-1. r3
Owners_. /• Address
- Byr`.`AddresS�7o'
CONTRACTOR, AGENT b-t 1'I'•�j,
.f.' Phone Q , _� Approved '
- PLUMBING INSPECTOR
7IXTURES NUMBER MAIN DRAIN �.
I UNITS I FEES-11 ' IUNITSI FEES.
Water Heater
��_ I. Size �p
Water Closets y e- I Material C,..r
Bath Tubs o Curb
Showers ,'. ' To PropLine
Existing
'
Lavatories {/ °SII To Exg - 1
Kitchen Sinks /�[ _ 'Nq on 911,2211. pigj
Dish Washers lam'' I- ,• C UI` , i
--Vbftste Disposals I .S( - SII -. F- I. -r ' J
Wash Trays; I STORM DRAINAGE, I
Washing Machines I � ' �o=II Size
Water Softeners I Material
Bar Sinks I I To Main Drain
Comb. Sink s Traysl 1 II To Curb,.
Dental Units I 1 I I=
Deinking Fountains) -
Floor Drains WATER SYSTEM
Hoppers I Size'; .`;I I
r,I
Restaurant Sinks I I I Material ' 'I L•
Sand Traps TOTAL FEES
Urinals I I Fixture Fee �2
Area Drains I I I Main Drain Fee I °0
Water Leaders Storm Drain Fee
S s
� Sprinkler Vaives I I II Water- y . Fee
SEWER BOXES a-3aL''Peimit' Fee
TOTAL S°II ,-TOTAL FEE:n..r _Q'7,5_0
Partial Rough
Rough Complete 2 r
Final ] {• '
Bldg. Dept.
Office Copy
BUILDING INSPECTOR',- FFICE
CITY OF CUPERTINr
P-Sewer Connection 'Sanitary Permit No. ............ +
[,Q�Plumbing Final., 'Plumbing Permit No- ------F��. -�. -
Lot No. ........ �,
�-
Owner or Tenant . ..._.... _
At . --:-----.�..v. ...b... - _.
Tract ........-------
.......'. ...th,.1lyV.' , • - - - ...........
-tirq..
.......- -- - ---------
Date Connected ....--.............. ......._ ;.--.y =---
Date Final ....... ------------ ,
- . .:-y..... F
t
,.. ----Wit.... _ ..... r
PLUMBING IN EC R
Ill 7/61-500