1146 F y 095 I PEPPER T/1 EE LOT NO.
NO. STREET .-
N FOR PLUMBING PERMIT' '
® CYTY OF CUPERTINO
jum 16 1961
t .. ..
Date 195— Permit No. - -// `I( b
f CUPERTINO
GITI 0 � Fee $
Application'is hereby made'Eo the City of"Cupertino for a permit to install plumbing
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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.
P,' Use of Premises t
Owner LD/NM)1 ywe4l ny //L/1/1C Address / U rn
Address d G GI
t CONTRACI'OR�AGENT�t
Approvert
vt ��/n • L PLUMBING INSPECTOR
FIXTURES NUMBER -MAIN,DRAIN
• I UNITS I FEES IUNITSI FEES
1 Water Heater Size
Water C��osets I 3 � � Material . ;-,�t•� C./ �
Bath Tubs •� / � �� To Curb 7 ::�wa::�. " �
Showers2 ll To Prop. Linep:sr✓ :
Lavatories. 4 .� I To Ei
Kitchen Sinks / NoC nn. /l
Dish Washers I - l —�'! `ice_
eWaste Disposals
j&4sh -Crays I + I STORM DRAINAGE
t Wishing Machines Size
•Water.Softeners � , �� Material? 7
'Bar Sinks � jj To Main Drain I
Comb. Sink a TiayslTo Curb
Dental Units
Drinking Fountains) II -
Floor Drains l l ' ll WATER SYSTEM
Hoppers ' l l . , ll Size I
Restaurant Sinks MaterialI(,re✓. I
Sand Traps I I I TOTAL'FEES
Urinals I Fixture Fee
Area Drains- Main ZDrain Fee I /.00
Water Leaders I Storm'Drain Fee
Sprinkler Valves - I I Water Sys:3_Fee 1.2/.O U
Fp�yxE3
L9,.2.3 Il Permit Fee; I1.1,011
TOTALgr ,x.511 TOTAL FEE
RE OR OF SP CTIONO, ', y-
PartialRo:igh
Rough Comp to ' :• .� '1' �,t�`
Fin
Cupertino Sanitary
_ ..• i .+ fi{e Copy .
BUILDING INSPECTO.R'S OFFICE
CITY*OP"CUP TING
❑ Sewer Connection .- Sanitary `Permit No. :_!.•Q..�f��.� ..:.....
Plumbing+ Final Plumbing Permit No. ..)117-(-0.............
' Owncr or Tenant .- -._ -/-------.._------
'of NoNo----- (er
. --.. .. ---- -- ` ---------.. -... 1„�-- .....:.......
• ..�_ I . .. ............... ----
Tract ................
'Date Connected _...............................1��,7 ..............,19
•'.,. ,Date Final ------------r--- ........... .... ....................................
1/
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is
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'• - i i moi) /PLUMRING INSpEcrOR
p•' tit il6o-500 'F ✓ ”