1937 lr l 8 GAN �2-• LOT NO.
NO. STREET
Lf FOR PLUMBING PERMIT
OF CUPERTINO
Dat � WRT�v�3 19 3 Permit No. ` Z7
�,�Y; OF CUPEPTII Fee /l�• o
A ca on Is hereby ma a to a City of Cupertino for a permit to install plumbing
r 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
•a
h Owner Address
By r — dikAddress/
CONTRACTOR, AGENT
Phone O Approve
'WIRING INSPE OR
1
UR Ub BI Ii�-- M I �R
-- I UNITS FEES I UNITS FErS`'
Water Heater I !•00 Size "' f
Water Closets 1 �, •0011 Material- -C't
Bath Tubs •.3 1
To Curb'
Showers !•o OI To Prop. Line X
Lavatories —�' z,pp�� To Exrstmg
,, chen-Sinks / I t- ooll Not _'or),
Dish Washers ISEWER__�_
Waste Disposal
Wash Trays STORM DRAINAGE
Washing Machines 7-6-011 Size
Water. Softeners Material,
,Bar Sinks Main Dras I
Comb. Sin &T&Trays 11 To Curb a
Q�c a'1 Units I �_�,5
Drinking Tountai ns l I,
Flopr-Drains �� WATER SYS'I�,EM
4loppers Size
.Restaurant Sinks erlal COO r
Sand Traps TOTAL FEES
Urinals 1�Fixture Pee DO
Area Drains Main Diaih Free I 400,'-
Water Leaders Storm Drain Pace
x Sprite nkler 1Jawce �� V(/etei Sys FCeca '
Permit `Fee FZN05C ":
TOIL TOTAL` FEE4-
RECORD ' - I:CTION- u - I
r Rough Cornplet — z � � �
9