1456 g®I.o-4 �-AV�A C LOT NO. /
NO. STREET
® 1 FOR PLUMBING PERMIT
OF CUPERTINO
Date AR 961 191 % Permit No. t
C' CITY OF CUPERTINO Fee $
Application is hereby made to the City of Cupertino for a permit to install plumbing
N 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.
vUse of Premises I h A v1-A
.. Owned AddresMo CA#44 ( 1 4 c
By 'k)'( PER- Q ES Address l O-9 t
CONTRACTOR, AGENT
!!!//5l- phone 1- b 4 O APProve -
PLUMBING INS PECTC
LURES NUMBER MAIN DRAIN
UNITS I FEES UNIT51 FEES
Water Heater ISae
Water Closets �" �� Material Cl
Bath Tubs t 1 To Curb
Showers To Prop. Line
Lavatories 9. �� N Existing
Kitchen Sinks ,� 1 � �� NQ on ,� 2-
Dish
Dish Washers
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Machines �ISize
Water Softeners Material j
Bar Sinks I To Main Drain
Comb. Sink'a Trays I. 1I .To Curb
Dental Units II
Di•inking,Fountainsl
'Floor Drains WATER SYSTEM '
Hoppers Size
Restaurant Sinks 11 Material der AL —
Sand Traps TOTAL FEES
Urinals Fixture Fee
Area Drains Main Drain Fee
Water Leaders Storm Drain Fee
Sprinkler Valves II Water Sys. Fee
Permit Fee
TOTAL TOTAL FEE 5r—)
R CO D O I }'ECTION '
Partial Rou� Z z
Rough Complete
Final
'Cupertino Sanitary
Office Copy
BUpLDING :INSPECTOR'S OFFICE'
CITY, OF CUPERTINO
❑- Sewer Connection _, .- .,•, SinitaryPermit No. ..:a /�
.... ......
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'`Plumbing Final - Plumbing .Permit No. �T'✓-.(4........ - '
Lot' No
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I
Owner or Tenant.
. At .. /G .. /
Tract ' ! - - ' •.` '
-- ---- - ---- -- - - „..- '
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Date.Connected ------------------------ -.---- ---
oe
Date`Final ....................
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INC
PK 7 fINSPECTOR
111 1/60-500 -