2325 (2) --�14ti-"J crenge iia® Tana - LOT NO.—
NO.
O.NO. S't EET
s _ AMI TION` FOR PLUMBING PERMIT
DCITY OF`CUPERTINO
FJ'AUGAUMP 19J6 Permit No.
CITY OF CUPERTiNO Fee $
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 applicable thereto.
Y Use of Premises Residence
Owner B10ss6m Valley Homes Address 10;5A Orange Tree TaIIe
T— -'-gy AmaraT Plwnbi -- Address 0
CONTRACTOR, AGENT
Phone A.26-3963 _ Approve
PLUMBING INSPECTOR
FIXTURES NUMBER MAIN DRAIN
UNITS FEES IUNITS I FEES
'Water Heater Size
i
'Water Closets I ,� � Material C�
ath Tubs j a D To Curb'
Showers �.�%d To Prop: Line ✓
Lavatories To E ' I.
Kitchen Sinks I j �/ d-p�� onir. (�
Dish Washers I ,z 1,,Z/ SEWER BOXES
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Machines j j�r-d IIS Size I '=
Water Softeners Material
Bar Sinks To Main Drain
Comb. Sink a Trays To Cur-b-1
Dental Units it
Donkin g,Foibntainsl I iI,
Floor Drains WATER SYSTEM
Hoppers I Size
Restaurant Sinks Material
Sand Traps TOTAL FEES
Urinals Fixture Fee
Area Drains Main Drain Fee �, wo
Water Leaders Storm Drain Fee
Sprinkler Varves I I II .Water Sys. Fee e"P
II Permit Fee I ;2- "
TOTALI j2 V�.s o II TOTAL FEE o-o
AREOR OF I. P TION
Partial Rough Rough Complete -,�
Final