1908 S 74;V �iy LOT NO
NO. STREET
ARPLK: �1ON KFOR PLUMBING PERMIT
JAPE 7 1963' OP C1rPExxruvo •
Date 194 Permit No. � l
CITY 07 rl'PERTINC Fee$ ao 0-h
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.
L Use of Premises
:4 v
y OwnerAddress
Addres V It
CONTRACTOR, AGENT f �f
Phon t,n ` rs « Approve
PLUMBING INSPECT
SRT IfF MB I DRAIN
UNITS ( FI..d IUNITS I FEES
Water Heater size s
Wates Comets V Ma al F �—
Bath Tubs In rb
Showers / To op. Line
Lavatories 1 13 1 11 To
Kitchen Sinks / 1j' N n
Dish Washers
Waste Disposals
Wash Trays � �� S ORM DRAINAGE
Washing Machines / �_ �� SizqS
Water Softeners —� a real j
Bar Sinks I o Main Drain
Comb. Sink &Trays To urb
Dental Units
Drinking Fountains)
Floor Drains WATER SYSTEM
Hoppers L$ize
Restaurant Sinks Material
Sand Traps jl < TO AL FEES
Urinals Fixture F
Area Drains Maim I)r, Fee
Water Leaders Storm Dr. ,Fee
Sprinkler Vaives I II .Water Ny ee
Permit F
TOTAL TO AL .
RECORD OF INS ON
Partial Rough —
Rough Com to w
Final —,3
Pq pap�
3 0�
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5. H
• C
G � � O O Own' •�