1288 Z-oq UE LOT NO. \L/
OCT� �PPT T POR,'PLUMBING PERMIT,,
�*' OF CUPERTINO
Dae
ITY (W CUR 195_ Permit No. /C;Z9y4
Fee $ t�' ��C)
Application is hereby made to the City of Cupertino fora permit to install plumbing
'pipes and/or fixtures listed on the reverse side hereof, and agrees to install°s'aid�prices
and/or fixtures in accordance with the provisions of the Plumbing.Code of the City of
Cupertino, and all other laws applicable thereto.
,
I &�' Use of Premises
:an
Owner /\ )Pk E. ( %/b��._ Address436
By I _ II4) Address O TOQ t
CONTRACTOR
Phone C L ��f-� _ Approve
PLUMBING INSPECTOR
�—URES NUMBER MAIN DRAIN
UNITS I FGES I IUNITSI FEES
Water He?ttr I I I. Size
Water Closets 11 Material ',: C1 I
Bath Tuba / II To Curb _ '..'14,j_' j
Showers / II To Prop. Line:j 1
Lavatories To-Existing.
Kitchen Sinks / II •No o�J�7 yJ
Dish Washers
Waste Disposals / •' .�I 1 ! I`�
Wash Trays STORM DRAINAGE
Washing Machines I "I Size Pa$
Water'Solteners ._ Material
Bac Sinks'c . I -. I To Main Drain`
Comb, Sink's'Trays II To'Curb '
Drinks Units ' iI '
Drinking Fountains) I iI `,
Floor Drains- WATER SYSTEM
Hoppers . .. ' Size T ,,•
37
Restaurant Sinks -Material'
Sand Traps 11 TOTAL FEES
Urinals Fixture,KeeSO
Area Drains Main Drain Fee • OO
Water Leaders Storm Drain Fee I
Sprinkler Valves Water SYS. Fee I / .p 0
SEWER BOXES lq.So ,.". II "Permit Fee J. I . O O
TOTAL TOTAL FEE iC( o
RECO_RD OF•. SP ION
Partial Rou,Ah G+
Rough GorMlete
Final - G•� ' '
c , .
..r _ Cupertino.Sanitary
aaOffi�C py
BUILDING INSPECTOR'S OFFICE
.rl CITY OF CUPFRTINO
�• ewer Connection I
� .,..S._ _ Sanitary Permit No. ..�,1.... .-----�++ ......-....
j/Plumbing Final - • ' Plumbing Permit No. . ...
. . Lot,-No. --- .................. .
Owner or Fenant --
------------------ ------------
-% �
At .....r...99 ..... . :...v ..... ..... ... , .. ......
.Tract ......... ---Z%/I. alw'•a.C[/ ....
........_...... .............. -------
Date Connected ...............:.....:.......... o%' /
.../.... .................. 1�..G....
Date Final ....
------ -------------------------...,l..f.'. .7....._............................................. 19�,1--.
-
07 VI
' /1?LUMBING limpwrOR '6 j�;