270 / OOt / 0 I ' L�-/`.lk. LOT NO.
No.
® �O/fPPCI FOR PLUMBING PERMIT
P01960 OF CUPERTINO
Date / / �
1 � Permit No. ? d�
CITY OF CUP Fee $
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 Premises
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Owner--P/-,7 27 F JL/� Address&qD'�� ✓
By WINCHESTER P, Address /
999opViAi6.ORWE ✓
Pho Approved/ L
PHONW CH 3-3"0 PLUMBING INSPECTOR /12.J
I�I] IURE NUMBER- MAIN DRAIN
UNITS I FEES II UNITSI FEES
Waver Heater I SOI Slze
ater C osets �,d-Q �� Material
Bath Tabs 11 To Curb
Showers J, To Prop. Line
Lavatories
--)a�da To Existing
Kitchen Sinks ��r e9 1 onn... y
Dish Washers
Waste Disposals
Wash Trays _ / STORM DRAINAGE
Washing Machines d-Z) Size
Water Softeners Material
Bar Sinks To Main Drain
Comb. Sink &Trays To Curb
Dental Units
Drinking Fountains 1
Floor DrainWATER SYSTEM
Hoppers Size
Restaurant Sinks Material
Sand Traps TOTAL FEES
Urinals Fixture Fee
Area Drains �� Main Drain Fee /,OV
Water Leaders Storm Drain Fee
Sprinkler VaivesI II Water Sys. Fee / ,d—O
Permit Fee r
TOTAL TOTAL FEEp p
RECORP OF INSPE
Partial Rough 2♦ G 0
Rough Complete
Final
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2 % �
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