1384 O.
NO. STERE
A`P _ 1 FOR PLUMBING PERMIT
OF CUPERTINO
?JAN 17 196 �
2 U '
07 Date 195— Permit'No.
cw CITY OF. CUPERTINO Fee $ l s
Application is hereby made to the City of Cupertino for a permit to install plumbing
` 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 ther
8 Use of Premises
v
V Owne I Cz 0 Address Q-dti
By )� Address
CON CTOR, AGI
I -a 'hone - 9 Approv
PLUMBING I`P CTOR
L`
A
FIXTURES_ NUMBER MAIN,DRAI
I UNITS I FEES 11 .";UNITSJ"FEE
Water Heater - . II Size - I . ., -
Water Closets ,.I Material
Bath.Tubs - To Curb _ L'
Showers To Prop. Line'
Lavatories c . 'I . 11%,To Existing I. - I
Kitchen Sinks . , ' Not Conn.
Dish Washers
+Waste Disposals,: - -
ash Tra��':,=_ ,a;-. , STORM DRAINAUE-
mV3ffim g Mac!4ncs I �� - Size
�dulet Softeners: " Material
-Bar Sinks— To.Main Drain
Comb. Sink a Traysl II To Curb
Dental Units
II
Dtihking..Fountainsl II ,
Floor Drains WATER SYSTEM
Hoppers - Size
Restaurant Sinks I Material, I
Sand Traps I TOTAL FEES ��...
Urinals <���. Fixture Fee z I`
Area Drains • II Main Drain Fee I . 1
Water Leaders II Storm Drain Fee+l,,� A4S
ri kl Va N II Water Sys. Fee_I_.,,
.Permit Fee
TOTAL I I TOTAL FEE 'X6'
ECORD OF INSPECTION
Partial Rough
Rough Complete
Final S to