1258 /023%) G�ESTERN /l/� /yE LOT NO._
NO. STREET
�- �a PATION FOR PLUMBING PERMIT`' '
TY OF CUPERTINO
' 195— Permit No. y 3
a S�
�i nt T /���p�p��p�n� Fee $
I lri'P i t is<Jt�gCFW1g offie 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
Ps
Cupertino, and all other laws applicable thereto.
t Use of Premises SSS/lJE7l/�E
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Owner Address S E
By PV ! OLV B/ tJ, Address Am G
CONTRACTOR,AGENT
�Phon F /� Approv
PLUMBING PECTO
7
UR;i J,
FEES;
I
_ UNIT 5,1 FEES 11 N
Water Sizeq
�ntcr ,
, . 1, -
iter, As ts Material �0 , .
�Bith TpL1 To Curb 1
1
Showers I To Propqlllffine
To Exisfihgt
avatories.
71
Kitchen�9,dksj N Cli),
Dish washers
Wj-tq saig.
Wash T'ray STORM DRAW Et
Washing Machines 11, Size
.WaterSofteners Material
Bar Sinks T"11 A n Drait
omb. Sink Traysi To Curb
Dental U66
'ry
Drinking Fountains)
Loor Drains _WATER vy SYSIgEM
_Ffuo�ppersi
Restaurant�Sinks Material
Sand Tf ps 'TOIAW,FEE*
rinals Fixture Fee, F10
—7n,
Main Drain &4
I_JJS(�rrmn D�ZT ER
Water Leade 11.1 IV7
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