1655 (2) /Z9 - I .� LOT NO.
NO.
EftR PLUMBING PERMIT �
JUL 2 7 1CUP
Date — 2s I� Permit No. V
Fee$ ___
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Application is hereby made to the City of Cupertino for a permit to install plumbing
7 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
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N Owne Address
By Addressl _ �' ec.:�✓�,'
CONTRACTOR, AGENT C
Phone �sH p, g �/y 7 _ Approve 1
PLUMBING INSPECT0
FIXTURES NUMBER MAIN DRAIN
UNITS FEES UNITS FEE
Water Heater Size ( —
Water Closets _ II Material C7 . I I
Bath Tubs I I II To Curb—1 I
Showers I I II To Prop. Line I I
Lavatories I I II To Existing
Kitchen Sinks .I I Notccof
nn. 9a Z.
Dish Washers I I ;• I SEWER BOX 9 Isa
Waste Disposals I II LL I
Wash Trays 1 II STORM,;DRAINAGE
Washing Machines I II Size ir I I
Water Softeners 1 11 Material I
Bar Sinks I ,II To Main Drain I I
Comb. Sink &Trays II To Curb I I
Dental Units. I I�
Drinking Fountains)
Floor Drains 1 II WATER,,SYSTEM
Hoppers ` . I I II Size 8; I
Restaurant Sinks I II Material',,'
Sand Traps I II TO,TA)E,FEES
Urinals I II 'FixtureAzeea, I ,
Area Drains I I II� Main Di•a'inftee , Qp
Water Leaders L 1 II Storm Draiu;�,k I
Sprinkler Valves I I II Water Sy Fee I t oD'
F II Permit Fee /,
TOTAL I _TOTAL FEE
R O ECTION
Partial Rou h
Rough Co lete V/ .
Final
Bldg. Dept.
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
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❑ Sewer Connection SanitaryPermit No. .....��...(ow2
Q4 Plumbing Final Plwnbing Permit No. -//443__.--
�; Lot No. ....A......._.-_._.
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Owneror Tenant ------ -- - ------- - -- ..... --.. . .-- .- _._.---.-......-..-.
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Tract .----------- -- - -- - ----
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Date Connected ...._---- ------------------ —._- Z!� S;S6 t 9 2..
Date Final ----------- -
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I fy UMBING -INSPECTOR
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ttt 7/61=500 •