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1280 19q �o f1'LA2 2E LAL LOT NO. � NO. STREET - FOR PLUMBING PERMIT' D ' fY OF CUPERTINO Date 195_ Permit No. I Z9i CITY OF GUPERTINO Fee S 63 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 saidprices iI and/or fixtures in accordance with the provisions of the Plumbing,Code ofithe,City of Cupertino, and all other laws applicable thereto. � Use of Premises ' Owner I� 1P1 I I�i�CS AddresY3o 6A ByDo ES Address/ S C2 I CONTRACTOR,-AGENT one f--.*v 4 Approve ' ',PLUMBIN INSPECT II SURES NUMBER MAIN DRAIN UNITS I FEES IUNITSI FEES Water Hciier ,• 1 f 1 II Size - Water Closets �� Material_ - kS , Bath Tubs, To Curb' Showers To Prop. Line Lavatories To Existing' � • - Kitchen Sinks NotrCo0 �/� Dish Washers �' ;� I� - - �� d• Waste Disposals Wash Trays STORM DRAINAGE Washing Machines I SlleI 'z W : ater Softeners Material. <� ' Bar Sinks I. To-Main Drain,jiit+'A I Comb. Sink a Traysl I To -Curb Dental Units I ' Drinking.Fountains Floor Drains WATER-SYSTEM HSize Restaurant Sinks Sand Traps r I TOTAL FEES Urinals I Fixture Fee,9' (- Area Drains r - -,JI—Main Di`ain;Fee Water Leaders ;•, Storm D?rain Fee Sprinkler Valves I I 'I Water. Systj Fee SEWER ©OXES I Permit FeO. TOTAL I A21 „II TOTAL-FEE, RE 'O OF N TION . Partial Rough Rough Cgle / q .f x Final Cupertino Sanitary BUILDING'.INSPECTOR'S OFFICE ' -' , CITYOF., Sewer Connection, . _ _:_.___--__---- ❑ _ ..Sanitary Permit No:..r_�1�70 ".. [q�Plumbing, Final ; . Plumbing 'Perinit No. _/- ."9,,-j ., �• Lot N ___ - Owner or Tenant ..--te ��1 '' 4 ` _. U t.....- .... " .. At ....�l.. 9N.d:.:........r .:..f/ ii/ . Tract.ir ... .mow ....................... I` Date -.t+`a",''e+,` „ter; �. .. Date FinaI ,--- _ ,\�.- . .. ..- . �f�' ..-.- .. ...... �r�60-500 i5L P[CINIBING INSPECTOR *ea