1379 L--A iv, LOT NO.
.� NO. �� _ {
® �A'P>Zmt l FSM FOR PLUMBING PERMIT
JAN 12 1962 OF CUPERTINO "i
Date 0 '4-Z 2 Perniit'No. 40 7,
.r . fFee
Y
Application is hereby made to the City of Cupertino fo�ia+�permit to mstalC plumbing
II , pipes and/or fixtures listed on the reverse side hereof, and agrees„to'inZtall said prices
and/or fixtures in accordance with the provisions of the Plumbing_Code of the'Ci _of
Cupertino, and all other laws applicable
thereto.. _;_S, '
t Use of Premises
WV. -�o.M t..�.o 1-
Owner '�� Address
By 1,7
Address
�.'i'�:'i-coN�rliecroa,.nceNri � r
) Phone .i�_ �:_:- ;t �_... ., ,- APProve
Cy �/c t PLUMBING INSPECTOR
�XTURES NUMBER -MAIN DRAIN
UNITS FEES (UNITS FEES.,
Water Heater _II ,Size _ I '
Water-Closets I 'Material
Bath Tubs I ' p[,To Curb.
Showers ' - '- i II;-To�Prop. Line 'I
`,Lavatories II To Existing
Kitchen Sinks. - ' , I'},Not Conn. _ I I
Dish Washers
Waste Disposals
Wash Traps3--- z` t I I STORM DRAINAGE {'
Washing Machines -. 8a, ;,�;:•Y;- it Size
Water, ten�}'S`i'g'L: >, �. > ,,I Material I 7
Ba ...- ,,,,. f' °.,...Ida✓ To Mam Drain . t
Comb,Sink a Traysl•>-k I II To Curb
Dental Units..
Drinking Fountainsl •g[kF— it
Floor Drains 1 :..:1'"th.�;.7i WATER SYSTEM
Hoppers 4. Si'ze <.^1,
Restaurant Sinks II,-Material'•;;
Sand Traps """ .Ya" •,TOTA'L BEES, k
Urinals - .13,; I I Fixture>Fee:.•`; I��' Jar
Area Drains
Water Leaders i Storm Drain'Fee a ' J
Sprinklery,,, - -=: "` ',`II _Water Sysr�Fee,ej
SEWER e0XFg f* � IJ.-Termit Fee`s
TOTAL I II•,`,TOTAL FEE
_RECORD OF' INSPECTION;
PartialRoagh"-.-' t,..�,.., .- -: 't._'F,.•::�.-^.::. .1.:
Rough Complete;. `, ,.,'
Final - �j ii2 . . ,. .• �