1910 NO. STREET LOT NO. 'v
�� � as
rr i P CAI_I�I�FOR PLUMBING PERMIT
!Y CI
OF CUPERTINO
Date .� ars 7 1953 +(�
1973 Permit No. l =] I D
ClT.X. C C''dERTINO Fees a o
"Application is hereby made to the City of Cupertino fora permit to install plumbing
-pipes and wli£'tutes listed'on the reverse.side hereof, and agrees to install skid prices
d/br 5xtures`? tdanceEs' ns of,tfie PlGinbing_Code of the City of
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and,aU other laws applicable ihereto.
8 Use of
Owner
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. } gyf! ' . :,1•.". Addr s
COMAACTOR, AG HNT ,
J Phone�'�/�`.r+» %r !� Approve
PLUMBING INSPE R
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�iS �URIS NUMBE M
I UNITS I FEES 11 IUNITSI FEES
Water Heater i �I Size
Water Closets 9 Material
Hath Tubs To Curb
Showers � � � 11 To Prop. Line
Lavatories 1=-1--- �� To,,�1'xtstm
Kitchen Sinks ( _ �� on
Dish Washers I ( it SEW XEBl
Waste Disposals
Wish "frays STORM DRAINAGE
Washing Machines I / Size
Water Softeners 11 Material I
Har Sinks 17 To Main Drain
Cpmb. Sink &Trays 11 To Curb
Dr' e Fou tains II, t _
Floor Drains 11 WATERS 3
Hoppers Size _el"
Restaurant Sinks Material
Sand Traps TOTAL FEES
Urinals Fixture Fee : '
Area Drainsj Main'Draih Pee ^^
Water Leaders Storm Drain Fee
Sprinkler Vulves I I II Water Sys. Fee
�� Permit Fee
TOTAL T'fel �� TOTAL FEE aft
RECORD OF S N
Partial Rough
Rough Com to —
Final
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