1147 " 0 9//, I PFPP'R rip's LUT No. 7
' NO. STREET
FOR PLUMBING PERMIT
{� I OF CUPERTINO
V 6 lobi
Date 195_ Permit No. '
CITY OF CUPERTINO 'Fee
Application is hereby made to the City of Cupertino for a permit to install Plumbing
Npipes 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
Vi
Cupertino, and all other laws applicable thereto.
8 Use of Premises ",5W t-1Vr h-
y OwnerCd/H��iuW��.t>N B�DRl Address a
By " L!i/!/ /vG _ Address
c cgN rxwcroR ncexr i
Phone //= /// Approved
�•�/ 1,4, I PLUMBING INSPECIO R
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I'
SURES„ NUMBER '11 MAIN DRAIN
UNITS 1 FEES UNITS FEES
Water Heater - 1 Size•,_, : Nn
Water (,;!,)Sets I,' 'II Material
Bath TuE. I 1 I To Curb. . '
Showers :. y, ' To Prop! Line'- �rI
Lavatories I 3 II-To ExiggZ
Kitchen Sinks , . / • I
Dish Washers ''
Waste Disposals
Wash Trays h „`' STORM.DRAINAGE!
Washing Machines I J II Size �V.'l ;t,'Al
,Water Softeners Material : '7�•' (.' G'j 4
Bar Sinks _ To Main Drain•, t!.
Comb. Sink&.Trays) To Curb _
Drinking Fountaigsj II
Floor Drains I 't t 11 WATER SYSTEM
Hoppers I I Size / i-
Restaurant Sinks Material . GA.c✓•
Sand Traps I I TOTAL FEES
Urinals Fixture FeeI f
Area Drains I I I Main Drain;Fee /,UU
Water Leaders Storm Drain_Fee I
Sprinkler Yalvcs II Water Sys.:-Feey'SI 1,jo
�Fhe Permit Fee-I" '`I/. Du
TOTAL V(,,aj TOTAL FEE; ly.,2S-
REC RD F INSUCT
Partial Rough / ti
Rough Camplete -
Finj �•� 2
Cupertino'Sanitary
S :
BUILDING INSPECTOR'S :OFFICE - W :
CITY,OF CUPEkTINO
Seiner Connection � 3
❑ - Sanitary Permit. No: r. .-
Q 'Pluinbing Final Plumbing Nrmit'No.,./ --V,7
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. . -Owner or Tenant i
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Date Connected --`vµ-,. . � A • t. -1-.
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Date m .... ; . .. qz/v
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d ., /BLUDiRING INSPECTOR
111 1/60-500 (% ..