1533ly
NO. STREET
rolRPM6 AN' OR PLUMBING PERMIT
MAY
TY OF
1 19�[TI Ci CUPERTINO .
[[ , 195% Permit No. c7
CUPERTINO , Fee $ .2 2.5
Application is hereby made to the City of Cupertino for a permit to install plum�g
pipes and/or fixtures listed on the reverse side hereof, and agrees to install said paces
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
APARTMENT
PHILIP RAFALOW, INC.
y200 Cristic Ld1 e OTOR, AGENT
Ph001hpbell, 6alifornia T pl"' 37i•5660
7 a7 cYY�-��w,�—��• I
Address• P ,
Addre
Approve
PLUMMNG INSPECTOR
FIXTURES NUMBER
MAIN DRAIN
UNITS
FEES
UNITS FEE
Water Heater
/4^
Size
Water Closets
41 °D 11
Material C
Bath Tubs
To Curb
Showers
To Prop. Line,'
Lavatories
Tos rg
Kitchen Sinks t�
,c�( ° O
Ndk Con ,? 7
Dish Washers
Waste Disposals
Wash Trays
STORM DRAINAGE
Washing Machines
7,j1
Size
Water Softeners
Material
Bar Sinks'
To Main Drain
Comb. Sink s Traysl
To Curb
Dental Units I
�I
Di•iiiking.Fountainsi' �
Floor Drains
WATER SYSTEM '
Hoppers
Size
Restaurant Sinks
��. Material -q, 6/1
Sand -Traps,
TOTAL FEES
Urinals
Fixture Fee
Area Drains Main Drain Fee
Sr,rinkler Vawes I 1 11 water oys. rec I.
WA
'- `• ' - Bldg. Dept.
. 1 J Office Copy
�>: q BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO tt
�er Connection .Sanitary Permit No. -�� j-------;
lambing FinalPlumbing Permit No. J"..
Lot No.....
Lit..
Owner or Tenant ...........--------------- --
.............._-
....... ......... QL_S�
......
.....I , -...f'...
Tract .._-----"--------�� .
Date Connected ..... --- .... .....,. --r�.------------ 19.
Date Final -------------
PLUMBING INSPECTOR/ \
111 7/61-500