2478 /L
LOT NO.
O.
r N® EET
T CPLUMBING
G PERMITRCL
I F URTINO
0 NOV 5q9
3 Sanitary No.
LL
3 a Date %D- '�� 196— Permit No. /
=o CITY OF CUef T NIS" Pee $ as a
Application is hereby ma a to the'City of Cupertino for a permit to install plumbing
o a pipes and/or fixtures listed on the reverse side hereof, and agrees to itistall said prices
i N and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
< w Cupertino, and all other
/laws applicable thereto.
j Use of Premises ��/�i vim%
00 i i
> m
o a Owned/�Z��_; : /?M• Address
zJ Z� z By Address .' v
Q /�CONTItACIOA, GENT
0 a State Licens oZ 7 %
o - APProved�
qs 0 �
�/ PLUMBING INSPECCOA
la MAIN DRAIN
UNITS FEITS I JUNITS FEES
Water HeaterSize
Water C76—sets
Material
Rath Tubs To Curb
Showers —2 oZ To Prop. Line
i.;vaturies To Existing
Kitchen Sinks Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
\/ash Trays !,Z a. STORM DRAINAGE
Washmg Machines Size
'.dater Softeners Materiat
Rar Sinks To Main Drain
Com F Sink s 7rrys To Curb
Dental Units
Drinking Fountains
Floor Drains WATER SYSTEM
Size
Hoppergrnt�
RestauraSinks Material
San raps TOTAL FEES
rinals Fixture Fee �a
Area Drains Main Drain Fee
Water Leaders Storm Drain Fee
Sprinkler Valves Water Sys. Fee
Permit Fee
TOTAL p 2241 TOTAL FEE
1 RECORD OF I SPE ION
Underground Rough,._
Partial Rough..
Rnugh Complete.. ��—
Main Drain
hinal... ri,
V