1149 O Q O l: I PfPPE/� Trt EE LOT NO.
NO. STREET
" " = ATj" fOR PLUMBING PERMIT
y UPERTINO' / l`
6 � t _ Permit
Dale RUM
^^11 ((�� PPEERRT7I^' Fee $___[_Z
Applicatlad�sYN � m'X�to Ife1City of Cupertino for a permit to install&l bing,
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.
7
E Use of Premises AGS/De'vct rt
_ v
Owner �D/HMavLv�etfV ALDRt Address N To P-
gy It g0 Y PL 1i/Nd/MG Address L
- CONTRACTOR, AGENT
Phone ��- (r— /// _ Approve
PLUMBING INSPE
I TURES NUMBER 11 MAIN;DR IN
UNITS FEES 11 ,ll . 11;>! IUNITS I FEES
Water Heuer I $iZe :i;l f-'! � I Xn
Water Cigsets 3 11 M3terial' {� ' I I C I I
Bath Tubs_ I 1 II- To(Cutb, 1( I;II - I
Showers-:I 2 'II 'iTo/Props Line_{II
Lavatories I I Toy Hi'sting'( {I-
`
Kitchen Sinks / II- No Co'
Dish Washers
Waste Disposals / • i { :4(f`�:a.`'(�. 41
Wash Trays II •' JSTORM;PjRjlNAGE
Washing Machines II Siie ,j. (;,a
Water Softeners
Bar Sinks To Mai'riallrain,;I? i,a; I
Comb. Sink s Trays l II To Curb'- '{ : I I
-Dcotal Units I 11 r4 •1 _J, iI_�
Drinking Fountains) I _ II t( d ;(r:(I
Floor Drains I WATER,SYSTEM
Hoppers
Restaurant Sinks_ - Material'}`= {j•,r." .:i`LI✓,I
Sand Traps !}TOTA•L4, EES '
Urinals -Fixture
Area Drains r I Main Draiii IFee �h ,o o
Water Leaders I Storm Drdiri'9Ei(II;;�,'f
Sprinkler Valves I I I Water $ySilFt{i_'ld '.I,p J
_ rkRsreA / 12 II Permit Fee 1�?'??I'J. o J
TOTAL
Y6,2J I TOTAL{FEE_•NAV.gam
( R O D O S TION 'f T4
Partial Rough
Rough Coihplet t,�
Fin§I
.. // „•a
d 7
Cupertino Sanitary
Office Copy
BUILDING-..INSPECTOR'S. OFFICE
,CITY OP,CUPERTINO:
Sewer Connection _. / .-•
❑ Sanitary Permit No. ...l .........
'�Plumbing Final, t Plumbing'Permit No. /. .
v LN 9
Owner or Tenant
{ / y w
t "Tract
„ Date4Co�nected i ......... .. l�.^ > zr�+ -r• "'1 / .
Date Final:' •`•' ''ew."��` ji , ^ r^- '«-5` ' r 3, ,y+F7v.•..,.M 9P�,w;'"
G_ &B1, I\SPECTOA'- - -'•'