1266LOT
A EE
._:� , PPLICATI OR PLUMBING PERMIT
pSEP 2 6 1961 G. OF CUPERTINO
9)
Date G1
Permit No. 1'2 -LC,
V Fee $ ' 4�5
Application is hereby made to the City of Cupertino for a permit to i stall plumbing
pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
and/or fixtures in accordance with the provisions of the Plumbing,Code of the City of
Cupertino, and all other laws applicable thereto.
u Use of Premises
Owner
Bdi , «V _ _LS AdIlk
CONTRACTOR, AGENT
/L17�honeCL /. 0
4-00
�aTURES I
NUMBER
MAIN DRAIN
I UNITS I FEES II
-IUNITSI FEES
Water Heater
I
Size '•
Water Closets
? II,-Material
Bath Tubs 'j
j
To Curb`;'
Showers
To Prop^i Line'-
, I .
Lavatories
Kitchen Sinks
I '"
To Existing '-c
Dish Washers'
Waste Disposals
Wash Trays
STORM-DRAINAGE
Washing Machines
/ 'I'
Size'
I; .1. ?I
Water Softeners I
I. Material's
I of •.`
Bar Sinks
I;To Main Drain
I !-I
Comb. Sink a Trays
II' To,Curb
—Dental Units,'.;.
.Diinkirlg Fountains)
II,I
`'
'
Floor Drains
WATER SYSTEM
Hoppers
-
Size
Restaurant Sinks
I
Materialry
Sand Traps
I
TOTAL FEES _
Urinals -
I Fixture. Fee�•l " (-
Area Drains
I Main Draih_'.Fee"
Water Leaders
II Storm DrainlFee I
Sprinkler Va4esI:
Water Sys, Fee
5W
EER n..=;
—II-Permit'Fee;;
ll
TOTAL
�j
11,.TOTAL FEE
mil 1:
BUILDING. INSPECTOR'S
CITY OF CUPERTINO
❑ Sewer Connection
Plumbing Final
Ow;ier or
At ....19.9/.:.:
Cupertino Sanitary
Office Copy
OFFICE'".
Sanitary Permit No- ---- : -- �-----*-
J-__
Plumbing Permit No... �?_S^......
Lot No. ....:.:....... ......
..
CJ1�Yt/�d------------- ------------ -------------
6
Tract..... _.......-...L-------------------------------
...
` '.. ,D.ate-Conne.ycted...... .......k...: .... -f- �- ............... _ - 1
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9
.D1te Final. .. ... .. 1 n
l
I f. t P,I;UTfRING;INSPECTOR .