868 (2) LOT No.,
STREET I .
/},yA�GG�1�P TU FOR PLUMBING., PERMIT
ITY OF CUPERTINO
t� ,� �Y ( IIICIdPP� lin 195_ Permit No.
Fee $�x
N
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
and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
Cupertino, and all other laws app 'cable thereto.
B Use of Premises
a
r01
Ii Owner �
'BpeAMARAL PLUMBING, I _ Address
i 336*qTNSCAOAANMT
P Phone BANTA CLARA, CALIFORNIA Approve
PLUMBING INSPECTOR
IX URES NUMBER MAIN DRAIN
UNITS I .FEES P 'IUNITS1 FEES
Water Heater iI Size I V4F
Water Closets - 11 Material � •
Bath Tubs ji To Curb
Showers 16111 To Prop. Line
Lavatories _ To Existing
Kitchen Sinks _ .� _ Not _R'"
ono d?
.Dish Washers /
Waste Disposals
Wash-Traysl 1 11 STORM DRAINAGE
Washing Machines I Sizc {
Water Softeners Material j
Bar Sinks To Main Drain
Comb.Sink &Trays) To Curb
Dental Units _
Drinking Fountains) II _
Floor 'Drains WATER SYSTEM
Hoppers Size
Restaurant Sinks Material
Sand Traps TOTAL BEES
Urinals Fixture Fee
Area Drains Main Drain Fee
Water Leaders Storm Drain Fee
Sprinkler Valves I II Water Sys. Fee
Permit Fee /
TOTAL I TOTAL FEE
RE ORP OF IVS 'ION
Partial Rough
Rough Complete p
Final r
t-�. ''• Cupertino Sanitary
' - - Office Copy
` BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
Sewer Connection Sanitary Permit No. :..L..Q- - (�� .:-. •. .
lambing Final Plumbing Permit No. ....-V-- ...:.+....
Lot
-:� 1- ..
Owner or Tenant ...---'...:'.v- _---- ------- ..L�...1.3 .1L:Q_ - - '....... .. ......._...-- -t
Tract ...-------------------------`---
DateConnected ----------- _.... ............ ..... .. .. .... .:...... ...._....... ............ 19_
Date Final -------------------------------- .........._T O - _ 1
_
i
.............-----.._.... ---•<.
PLUMBING INSPECTOR
ill 1/60.500