2002 LOT NO.6C-D6' /t y
Np. s E
PI
EMAR
,P .CION�FOR PLUMBING PERMIT
CITY OF CUPERTINO
29 3, ,;
Date 1963 Permit No.
CITY OF CU?ERT:^ Fees 76
Application is hereby made to the City of Cupertino for a permit to install plumbing
Q� 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 a laws applicable thereto.
I &' Use of Premises L C/>
In Owner-44e- �. A41' G¢ Address 'a")
-/9�� 3�9S—
ByAddress a O S
CO TRACTO , AGENT
Phone_ �'r/�f�/ Approved
PLUMBING INSPECTOR
MBER AI D AIR
_ I UNITS i FEES 11 JUNITSI FEES
Water Heater
/ iI Size
ater C osets Material
Bath Tubs ( rp To Curb
Showers To Prop. Line
Lres ' 1I To Exi v
Kitchen tchenSinks � /0�O � �� Not opn.
"Ipish Washers 1 11
Waste Disposals I�
Wash Trays STORM DRAINAGE
Washing Machinrc I Size
Water Softeners T Material —
'BarSinks To Main Drain
Comb. Sink a TraKsjj 11 to Curb
-Dental Units ii
prihkin ,FQuntuin II _
•Flout rains ,,,� - A SYSTE
:H pers
st lt�s
/ and Trap f 3 TOTAL FE'S
Urm s _� Fixture Fee 7� c
F, ea' ains Ma
,ip Drain F a r
J � rain
e
_. Pe It Fee eL
T TAL 1 071 1,71 iI TOTAL FEE
OZ =a1•-
Tartial R ugh teC 42'
Rough Complet a i
od
"Final '
icob ' "