933 (2) LOT NO.
NO. STREET
D
FOR PLUMBING PERMIT --
CT � � rr OF CUPERTINO
Date AT 1944; Permit No. a,?
CITY OF CUP€RTINO Fee $QA
Application is hereby made to the City of Cupertino for a permit to install plumbing
pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
l� and/or fixtures in accordance with the provisions of the Plumbing Code of the Cry of
Cupertino, and all other laws applicable thereto.
Use of Premises���"' �c
a
19
ti Owner Z Addres
By WIC
� 1" Addr
CONTRACTOR, AGENT
fi Phone �? 2 L Approv-
PLUMBING INSPECTOR
' �O l3
-7NUMBER I MAIN DRAIN
UNITS FEES JUNITS1 FEES
Water Heater � ,� Size
/r
ater Cosets ✓ �00 Material
Bath Tubs To Curb
Showers / 0 �� To Prop. Line
Lavatories _ 3On 11 To Exlst'
Kitchen Sinks % 11.iN' 11 No Con
Dish Washers=$EWER BOXES .
_ 7
Waste Disposals / 0-6' 11 l
Wash Trays 11 STORM DRAINAGE
Washing Machines Size
Water Softeners Material j
Bar Sinks �j To Main Drain
Comb.Sink & Trays To Curb
Dental Units I �� �_
Drinking Fountains � �I
Floor Drains 1 WATERS STEM
Hoppers _�_ Size
Restaurant Sinks Material
Sand Traps �� TOTAL FEES
Urinals Fixture Fee
Area Drains Main Drain Fee
Water Leaders Storm Drain Fee
Sprinkler Vnwes I Water Sys. Fee
GIL
Permit Pee d1.O'S� � k--
TOTAL j/6v;;,jj TOTAL FEE _
RECOR OF NSP TION
,:.Part~ ial Rough ,a —
,'.Rough Co plot
Final
i
Cupertino Sanitary
-Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
Sewer Connection Sanitary Permit No. .../. fo
....................
2�Plunting Final Plumbing Permit No. .....7.,s-7-3.........
I !v 1;0
Lot No. -,..Z..4....--------..-
Owner or Tenant
................. ................................................
Tract ................6.7............
Date Connected ......................1,012-2
....................................... ... ................................... 19
DateFinal ........................... ....2! -------- ----------------
..........................
it INSPECTOR
111 1160-500