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1106 (2)` ,20�sv ` I/�E'PPE�e TiPrF� L�,v�- �oT Na. � l � - wo. smeer ' � - �� TION FOR PLUMBING PERMIT � � ITY OF CUPERTINO -� , p� .t� , ,,� _ � : D �pPR 17 1961 , 195_ . Permit No. I �D� .- ' AC7� � � 'CITY 0� �L�P�RTINO �-� ` �'��Fee� 1 � `1� Applica ion is eceby made to the City of Cupertino fo� a permit to install plumbing ' � pipe4 and/orfixtures listed on the'reverse side hereof, and agrees to install said prices � and/or fixtures in accordance with the provisioos of the Plumbing Code of the City of vCupertino, and all other laws applicable thereto. ��2' Use of Premises /<<s/�d"NG L•� � . . , , a '....r v �.� �. ' � Owner LO/N/N0�/wNILTN B/OR.t . Address �� j. ' � . � °'�i - f By UR� ' � N r Address ' I '�I1� � e y � CONt7tACTOR, AGENT , � . Iy/(�//n� Phone `�—��-1P/// - Approv � �'/�` j I , — y. �, . PLIIM RJG INSP CTO ' 4 i � r. � � . 15 1 �y . . . � �,.�- � :,, TIX�URES NUDTBGR MAIN DRAIN, I UNITS I FGES II IiUNITSI FEES i Watet.Hcater � I II $i2C I I�l!�. � Water Clusets I 3' � �� Material � GI •-�' Bath Tubs _ �� '� . �I To Curb �� " r"�" '" Showecs � � I �� To Propl�Line �r�/� �.�. ' Lavarories � 3� � �� To,Ex��sting �� .- , Kitchen Sinks � I � �� N t on ,�/'J�J�� Dish Washecs � ' / � ��' �' . .`'' ' �; �/ =�. � Wnste Disposa(s � � � �� L �[i�[1„��, '.''" Wash Trays � " � �� ^STORM�DRAINAGE � W�shing Machines � 1 � �� Size. � I�"�':�`-� "'" � Water,.Soffeoers � � �� Matecial,.. �, ��'�, ' q, Bar Sinks' � I � � I . II To Main llrain,l,i.�. `�� ' Comb. Sink s Trays� . � �� To Cuib�- ��., •�^;-��:�, - -Dental Units � � �� - Y , �;.� Diinking Fou�tains� � �,I �� Ploor Drains I I I� WATER SYSTL � . � Hoppers � � �� Sizc � ? I— Restauran! Sinks � � �� '�4aterial 16;u✓� .,,_ Sand Traps � � �� TOTAL F�EES, J: �,'"' Utinals , � � �� Fistu�e Pee !�,`�fp.pU;' Area Drains } I � �I Main Drain Fee��_�,,:p-�^.., Warer,Leaders ' � � �� Storm Drain Fee �"r'�. ' Sprinkler Vaives � � �� WatE[ $ys. FCB '��OJ �� I I II Permit Fee €/.00.f�;"t, TOTAL � I II TOTAL FEE /3;� p�+ REC RD OF NSY ' ION �.•� � � Partial Rough / fp �'� . 'e.�`i Rough Complete ��i°a '�`�"� � -- - —�_"'�' . . Final Gz ' • - � �, . -`r".� -__ . � • �*^•.� .11 � — N�OTICE�OF ADDITIONAL CH,4RGE ��,,w .Ysn�d CTTY OP CUP�iRTiNO [�T imn (JUN i u°;O{Gj�NSIjE •POR 5 OI'FIC@ � ! .�� q...� �.� �y � Date ...._..:....�-:--..:�,,_. ,..._...---..._., t � '° Per � . . 9... .. mit ... .. ' ' ' � .' .• ' - - ..,. . . � t � . . ... _. "� ,,• • ,o,:.,_ t- v - To� -. _�"c�x� . �i �=�� : _ ;�:.. �: _ r..�v��-�_ _ . .._ �:;,�: Address ......_.. ,.�•_r...::......' . _�!: �//)' /� ...J.:."'_. �,.:� �.., _ .. . _�'-G+G.i'+ . - � ,..� � � l 6 .. Reason .............:["�IJuQ�l�, .. . _ . .a�. �..� ( . � ..._---..... ... ..........:.�..._... ... ..._.....---....---_..._...........--------- - - � ., ` ��<-,! ' � ob , • -• .. ; �... ::.......... ......_. .:._< ' '-• - -� tlM.�. -- ..._.._.... ......._................... , � ...3� — . ..... .. �� _ _ _. _. _. . . o.o__ .... _._..... r�Z::►� : Amount$ -_�Z C � Si�+n . _°,;......��.... _, `.--. ... ..' . .. ..._... � " -.. . . ...... .:' . iu( 3/59�3na � �