1459/ a Vim/G V LOT NO. I V
'140, STREET
® I R PLUMBING PERMIT
q�9+ �+ CUPERTINO
Date `` 19B� 5_ Permit No.
CITY OF CUPERTINO Fees I S So
Application is hereby made to the City.of Cupertino for a permit to install plumbing
I pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
r/ and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
Cupertino, and all other laws applicable thereto.
P,' Use of Premises
Ownert� 1�p1-l_ �A c Addrl' �R' O
By- JZ, e-01:A AddressO
CONTRACTOR, AGENT
3 Phone � L b k-E'a O Approved
PLUMBING INSPECTO
FIXTURES NUMBER MAIN DRAIN
UNITS FEES IUNITS I FEES
Water Heater I ( I I Size .141
Water Closets II Material I [at
Bath Tubs I To Curb
Showers I To Prop. Line
Lavatories _ II To Existing
Kitchen Sinks _� .I No( C nn. -y
Dish Washers
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Machines Size
Water Softeners Material
Bar Sinks- To Main Drain
Comb. Sink sTraysj,T-1 11 To Curb
Dental Units ;.
Drinking,Fountainsl II
Floor Drains WATER SYSTEM '
Hoppers Size
Restaurant Sinks j 11 Material I GAL
Sand Traps II TOTAL FEES
Urinals 11 Fixture Fee I • ,U
Area Drains 11 Main Drain Fee
Water Leaders Storm Drain Fee pf
Sprinkler Varves I - Water Sys. Fee 1 pC
O u Permit Fee 1 - OC
TOTAL I -CZ6 TOTAL FEE I IT
Eiwp
Cupertino Sanitary
Office Copy
BUILDING INSPECTOR'S OFFICE.
CITY OF CUPERTINO
� 4❑ Sewer Connection Sanitary Permit No. .....e.?/�/s��/.//:....f:d........
Plumbing Final ' Plumbing Permit No. --
Lot No.
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Owner or Tenant .. -
At ...
Tract ----------------
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Date Connected ...................'.---L7 . ... - ..._ /
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Date Final ....
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.qr7 .:... ..----............................................. --- 194-
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111 1/(0-500 IfIING 1NSPECfOR