1768 (2) /SOT/ /�ICL-L/ )/•C�ZG i-G1C/ �-A LOT NO. ^� '
r NO: -� STREET- �. ..
APPL�C 'TION FOR PLUMBING PERMIT
1::
ITY OF CUPERTINO
IkG 30 1996? I
Date D 194-1-2- Permit No. / 76 /
rrn
CITY OF. C!PERTINO Fee $ fig, e c
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.
Use of Premises
Owner � Address
By ti Q Address
CONTRACTOR, AGENT �7 _
Phone U /Y7 /--`l : ! — _ Approve
PLUMBING INSPECTOR '
1
SURES NUMBER MAIN DRAIN
UNITS FEES IUNITS FEES
Water Heater SiZe
Water Closets 2 , �� Material
Bath Tubs ( . To Curb
Showers To Prop. Lin
Lavatories To Exi g �.
Kitchen Sinks
Dish Washers 11SEWER BOXES I OC
Waste Disposals f ��
Wash Trays STORM DRAINAGE
Washing Machines Size
Water Softeners Material
Bar Sinks - 11 To Main Drain
':Comb. Sink s Traysl 1 11 To Curb
Dental Units0
Diinking.Fountains �_
Floor Drains I� WATER SYSTEM
Hoppers Size I.
Restaurant Sinks Material ' L e—
Sand'Traps TOTAL FEES
Urinals Fixture Fee /7, 00
Area Drains - Main Drain Fee
Water Leaders Storm Drain Fee
Sprinkler Vat Water Sys. Fee 00
Permit Fee 00
TOTAL C _ �I TOTAL FEE my
ECO D O I CTION
Partial Rough
Rough Complet I
Fina� �•
Bldg. Dept.
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
F� Sewer Connection Sanitary Permit No. — x
-D
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nc-'15'lumbing Final Plumbing Permit No,
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47
------7 L 5P NO.
Owner or Tenant ---
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At -----//
Tract ---------- - ------ ---- ----
Date Connected ------ L'-z-
...... ---- 19... ........
Date Final ------------------------......... --------- -- --- 19..16--2-
-- ----- - ----- ------- -- --
------------- ----INSPECTOR--- - --------- .............
UMBIIZ
111 7/61-500