1277 (2) LOT NO,
NO. STREET
PLUMBING PERMIT' "40
CITY .OF CUPERTINO
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.Date S 2 / l61yry 195_ Permit No.
CITY, OF CUPERI;INO Pee $---� �4
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.
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Use of Premises - '
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Owner hCY �o� E�. AddreA& (f44 3�7(;F
ByLJIL1E2 — �6tJi^ Address t O 4SPECTO
CONTRACTOR, AGENTlrhone � I 0�O D Approved • t `PLUMBING
MIXTURES I NUMBER,.11, MAIN DRAIN
UNITS FEES' 11 (UNITS 1.FEES
.Water Heater Size
Water Closets - .�� Material �S
Bath Tubs ( rll To Curb-
Showers ( - . 'w �� To Prop. Line X
Lavatories= - ,,�� To Existing .
Kitchen Sinks I �, - .,;��� No Corin
DIsh .Washers a,I
Waste Disposals
Wash'Trays 11 STORM DRAINAGE
Washing Machines I ( - '.)I. Size �.I
Water„Softener's ��� Material
Bar Sinks � ' ,- II To Main Drain I ,
Comb:Sink &Trays ;.1 .1. 11 To Ciirb I
Dental Units 11 ? " .. r� Dunking Fountains) - ' I I j 1
Floor Drains II WATER SYSTEM `.
Hoppers 11 Sii '. I3
Restaurant Sinks - 11 Material AI J
Sand Traps
Urinals �� Fixture Fee `s •,! t9r C
Area Drains II Maid,Drain-Fee J `
Water Leaders 11 Storm.Drain,Kee I
Sprinkler Va Wes II Water Sys. Fee
SEWER BOXES f II Permit Fee ' y� I•-:) ,^
TOTAL TOTAL FEE, 1 ,
REC R OFION ,(? f
Partial RCugh
Rough C plete
Cupertino Sanitary
-"OHice Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
E] Sewer Connection Sanitary Permit No. .....,...,._ ............
Plumbing Final -Plumbing""Permit No. .../.:' ... ----.
- , .
x• . . Lot No. . c!_'--............... .: ..
" bwner',or Tenant -_. Jl AO ----- .
Tract ----------- ----<<'��-'--.........----...-.�.................._.---.:._.--..........----....---::-:--....
Date.Connected•--- -,----- 1,23._......
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`--a'"='tDate�I•inal` " - .Z
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�-LUMBING INSPECTOR
lll�►1%CO-500 � � r� !•
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