687 STREET ry-l?"e.. J,IR, w=r:•.,L.
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APPLICATION FOR PLUMBING -PERMIT`..
CITY OF CUPERTINO
s
Date• �rLA�� �� �1Fi 195_ Permit No.
Fee $
o AQp�I¢atlo ts"hereby made to the City of Cupertino for a permit to install plumbing'
pipes and/or fixture1s'rI���4t� n reverse side hereof, and agrees to install said prices.
ands+fjxt ura in�C�Qrtla tfi the provisions of the Plumbing Code of the City of
Cu�r�tln , 141 all.other law applicable thereto.
Use of Premises
I a _
Owner /SEPI Address
BY Address Ol/
CONTRACTOR, AGENT '
Phonel .��Gro /G��/ Approved
'I PLUMBING INSPEQOA
717-IXTURES NUMBER MAIN DRAIN
I UNITS I FEES !f I UNITS I FEES
Water Heater 11 Site
Zf
Water Llosets Material
Bath Tu s / To Curb
Showers] / 11 To Prop. Lin
Lavatories _ To y pExisting ,
,tin
Kitchen Sinks.; ,� j �� Conn
i
Dish Washers SEWER BOXES j
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Mater' es I Size
(Water Softeners Material
Bar Sinks To Main Drain
Comb: Smk & Trays) 1 11 To Curb
Dental Units 11
Dunking Fountains) II
Floor Drains 1WATER SYSTEM
Hopper's I Size I j
Restaurant-Sinks Materia pL
Sand Traps TOTAL-FEES
Urinals �� Fixture Fee.:� ,O
_Arca Dr-a-msil Main,Drain-Fee
Water Leaders I .:�� Storm Drain Fee
Sprinkler Vaives II WaterSys. Fee
Permit Fee / n 0
TOTALTOTOTAL FEE
RE_COR OF-I SPECTION
Partial Rough
Roy Complete
.Final fs /
Cuj�ertino.Sanitary..,
.CopY.
BUILDING INSPECTOR'S OFFICE ,
o CITY OF CUPERTINO
a
❑ Sewer Connection Sanitary Permit No. .... //�a(:......�../..
Plumbing Final Plumbing Permit No. ..../;M/�7.....-.----
C./ Lot No. .4':J.`-..-.......
' V
Owner or Tenant ..-'- -........ - P!Ll..--... -.
At - C7.,. 5�5�-=---- -------- C ..c..,..__,_......................... .... .......
Tract ------------- ........... .1• ..
Date Connected ..-------_.-------+.. cG.l .................... ........................:....-._....... 19...
Date
Final _c...... 7 //
r , .
%59.500
KING INSPECTOR