1363 LOT NO.---(--'
NO..
® 11y FOR PLUMBING PERMIT •
OF CUPERTINO
M DEC 211961 �z
vDate I`'c'z - igiL Permit No. , `-'
CITY OF CUPERTINO Feed
MApplication 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 priers
O 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 Prenaises_T F/ [,c r -
:a
Owner .d o N "6:-. `// n�G � Address
By-&l �.�0A r 6/N f i Address ois o A?
f6
CONTRACCOR, AGENT
P ne O- -�o r Approve
PLUMBING INSPE OR
MTUM M i MAIN
UNITS i FEES !UNITS! FEES
Water Heater l tl V Size
a( ter Closets 1f 11 Material T
Bath Tubs 3 To Curb
Showers o Prop. Line
Lavatories �_ ��� To Existing
Kitchen Sinks
Dish Washers
Waste Disposals
Wash Trays t?v STORM DRAINAGE
Washing Machines Size
Water Softeners Material j
Bar SinksTo Main Drain
Comb. Sink & Trays To Curb
Dental Units
Drinking Fountains) � �I
Floor Drains WATER SYSTEM
Hoppers Size ---
Restaurant Sinks Material QA(
Sand Traps �� TOTAL FEES
Urinals I Fixture Pee�_ E
Area Drains Main Draih Fee
Water 1—ca—dersl IINorm Drain Fee
00
y,grinkler Valves ate[ Sys. Fee
Qwpq, ermit Fee _
TOTAL _ >1 TOTAL FEE 2
rfi 'r�:
t t
Rough Complete i
Final /
Bldg. Dept.
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
0-�Sewer Connection, Sanitary Permit No. .....C:,:-v .........
—,,-,[R,'Plumbing Final Plumbing Permit No. .........
Lot No. ....4�1_q.........
Owner or Tenant .....
//422
At ---
/=-//77---
e-.. ....Z. "'****.... ............. ... ... .......... .........
Tract .............
Date Connected ..................................
.. .. ......
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DateFinal........................................ 19 -
zPe..... ............ .........................
.. ...............................
PLUMBING INSPECTOR
III 7/6i-5oo, '