623/ O 7 4,./1�� �iVYVIT-Lt VI LOT NO. w;-• v
DIO. STREET P >•
APPLICATION FOR PLUMBING PERMIT
CITY OF CUPERTINO J
De 195— Permit No. -?3?JAN 201060 Fees
Application is hereby made to the City of Cupertino for a permit to install plumbing
pipes and /or fixtu a l`i to reverse side hereof, and agrees to install said prices
an -- - - t�;'- in (L4 - cd hi�itbthe provisions of the Plumbing,Code of the City of
Cupertino, and all other laws applicable thereto.
Use of Premises
Approve-PILLIAM D. BENUICH
PLUMBING INSPECTOR
I ) i I i. I I f
hIXFURGS NUMBER MAIN DRAIN `
s UNITS FEES IUNITSI FEES
Water Heater Size l
Water Closets Z �� Material �! `
Bath Tubs /
To Curb
Showers
l To Prop. Line
Lavatories
�� To Existing J. r l
Kitchen Sinks
N oqn:
Dish Washers
/
Waste Disposals
Wash Trays
STORM DRAINAGE
Washing Machines
Size l
Water Softeners
Material
Bar Sinks
To Main Drain
Comb. Si s, Trays
To Curb
Dental Units
Drinking Fountainsl I
l
II
Floor Drains l
WATER SYSTEM n
ren
Sprinkler Vaives I . I Ii Water Sys. Fee I / p d
Cupertint#'Sanitary
Office -.Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
F-1 Sewer Connection Sanitary Permit No . ....... 9zoef 7 ------
D,�Plumbmg. Final Plumbing Permit No . ...... .......
Lot 'No . ...... ............
Owner or Tenant ...... av,
At------- . . ....
.................................... .....................
Tract......................................... t
Date Connected ...........
Date Final ......................1,17.. ...... ............................................. ............ 19 .
d.
17....... . .. .... . .. ...... ................ ..... ...... ..... -- ----- 19- /Ovo.
111 7/59-500 �XUMBING INSPECTOR