1300LOT NO. -
NO. STEEET
ON R PLUMBING PERMIT.-
T I �jCUPERTINO
Date
CITY OF CUPERTINO
r
V
.-a
Permit No. /300
Fees 1-71 SO
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 thereto.
Use of
Owner /\ t C �/ Addr30 46l"7 1)QL4
AddressO�
C CONTRACTOR, AGENT
Approved
PLUMBING nE=
INSPECTOR
Heater
,?Waste Disposals
Material I n
SyAsh Trays
STORM DRAINAGE
Washing Machines
II Size
Water Softeners
Material
Bar Sinks
To Main Drain
Comb. Sink s, Trays
To Curb
Den al Units -.-• I
Dunking Fountains 1
II
II
.Floor Drains
WATER SYSTEM •��
' Hoppers IJI Size I_I
Restaurant Sinks
Material I n
Sand Traps
TOTAL FEE
' Urinals
Fixture Fee V4 -so
Area Drains
Main Drain Fee / , pp
Water Leaders
Storm Drain Fee
Sprinkler Vaives
Water Sys. Fee •C>
SEWER BOXES
permit Fee gyp
TOTAL4aI �n
TOTAL
Cupertino Sanitary
Office Copy.
`
BUILDING INSPECTOR'S;OFFICE
CITY OF CUPERTINO
1.7
- ❑Sewer Connection Sanitary, Permit .No....C�/��...._..
. „�.�
:..3dPlumbing Final Plumbing Permit No.
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3�!-
Lot No.
Owner" or Tenant ... ...... -- -- . _.. .... . ,
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Tract
Date Connected"`.- - 0
19.6 :
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DateFinal
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P. IMNING INSPLCt;OR-`r
111 1/60.500 i