154 (2)4^- /.� 'a..�.,W Fla
0/61 lXh�'D✓ ('k�� Vim' LOT NO. / .. �Z
NO. TREE w T`%" _'
LI -CATION FO PLUMBING PERMIT
LLf
MAY 1 F'ITNPP LP'RT1NO
1 DatecuptkPermit No.
�l O Fee $ a7
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..
8 Use of Premises APARTMENT
PHILIP RAFALOW, INC.
Owner Address
q�� So m Ae
1 bV %��r: % a; Q« Address T rv'
200,Cllslib "TRACTOR, '
Ph�71@ubell. California S`� -" Approved
Phone 377-5660 ty 4 PiUe fn—NG I E TOR
FIXTURES
NUDfBER
MAIN DRAIN
UNITS I FF.ES.I1
UNITSFEM9
Water Heater
/ /-711
Size' '!
Water Closets
_ � II
Material C„ i. ' ' -
Bath Tubs j
I S/! II
To Curb I:
Showers
/
r
To Prop. Line 14� -,
Lavatories
Kitchen Sinks
I q�_
�(t' 11:
To Existing I
Pcoll r(-2 ,1
Dish Washers
1
"'`' "°' ' I
WasteDisposals
°-I
''". .:-I.'.-I
ash Trays
7nWas r p'Machines I
� � •/ �I
,' S'IORMyDRAINAGE: +;
Size .. : •. a_. I�. '--.-'.I- '• ..�
'Water'Softehers
"`
Material`; ';r„-••',;;�,:�.,.,;->..I.
BariSmks
To Main
.Comb. Sink'a Traysl
1
II To Curb ,
I .i I^-
Dental Units_
Drinking Fountains
Flooit'Drains
WATER SYSTEM
Hoppers
Size
Restaurant Sinks
Material C.q vI
Sand Traps I
I„
I TOTAL FEES
Urinals ' '
- I
I Fixture Fee I
Area Drains
Main Draih Fee I .Z a2
Water Leaders I
Storm Drain Fee ,
Sprinkler Vawes
. I
II Water Sys. .Fee Ir,
.�,,�n
Permlt Fee / �l
TOTAL I
2 t,
I TOTAL FEE
R C RD ECTION _
Partial Rough v
Rough Complete _
Final
• Bldg. Dept.
Office Copy
BUILDING-)?SP,ElCtQ '-d-FOICE
� CITY
'
2r,osewer Connection
Lj/Plumbing Final
Owner or Teno
At ............... V
Tract ................
Sanita�y Permit No- ----
Plumb*ing Permit No - -----
..........
I ot N
............................. ...... .
.. ................
----------------------- - -------------- -
Date Connected .... ...... .
............. .................... 19—
Date Final
.... ...... 7 3 .. ..... . r ... . 19 ............
yf
-------------------- -------------
-B'l N G
j P L U'M' INSPECTOR,,
111 7/61:500.,