1219 (2) t V
O I PEPf =E" LOT NO.
N� 0 E •APPL 1 FOR PLUMBING PERMIT ,-,
L.� (SEP 12191 MM 1 OF CUPERTINO
Dat 195_ Permit No. 7/
Lb ////
Fee s_/sem=_
aApplication is hereby made to the City of Cupertino for a permit'to install plumbing, .
H pipes and/or fixtures listed on the reverse side hereof,.and agrees to install said prices.
t e and/or.fixtures in accordance with the provisions of the Plumbing Code of the City of
`^ Cupertino, and all other laws applicable thereto.
v
Use of Premises_ �L-"S/GE'iv C Z
Owner
�
1 s By PUBO Y'.�LVMR�/iv�!"�f�x daIC39Gif ��-^^"CA i r
} ..«.. CONTRACTOR, AGENT ..
l f3Phone '�- Approved
PLUMBtt G INSPEC R C
f1
I -FIXTURES NUMR&R, -MAIN DR.yIN c
UNITS FEES ' f _ 1 V&ITSI FEES
1 I Size'.' i ',j JAIN-
Water Hut '
Water Closets ;I, �I Material;
Bath Tubs To Curb,
ShowersIj To Prop: Line yjfe
Lavatories Existing
Kitchen Sinks { II No(Con X'/ %;•
Dish Washers I ! I tIi.•"'.
Waste Disposals I 1
Wash Trays ORM DRAINAGE
Washing Machines I ! I I.;Size '. d�yl4tirt•
Water Softeners I' I II Material :}f.I,71" .1^
Bar Sinks .I ��. To,,Maui Dtain"'� t
_Comb. Sink s,Trays TI�IoiCurb ` YJ %
I=
Drinking
DrihkingFountains I I. U '�' "•`IL,tI '
Floor Drains - I WATER'SYSTEM
Hoppers I II Size tiy 1j�—
Restaurant Sinks _ II Material;i„. I ypLV.I
Sand Traps M h, I •'TOTAL FEES
Urinals ji Fixture,Fee,+ I /3:S 0 '
Area Drains - •Maid.Drain Fee
I - ,II - _ !. . v
Water Leaders I • I t 11 Storm'Drain Fee I
Sprinkler Valves I II.,WateirSys.'Fee I /.D J
Permit, Fee ' D o
sL TOTAL
d a sc ;2,
• ' ” TOTAL FEE I!•
TOTAL . I- /�• �0
RE OR I CTION
Partial Rough 4
Rough C6',!p.�e ?'
Final
--.- -- — Cupertino Sanitary
- •r, v9ffic Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
❑ Sewer Connection Sanitary Permit No. ----- ...........
❑''Plumbing Final Plumbing Permit No. ... ---- ---
` Lot No. -----...../.�.------------
Owner orrTenant -
nr_ ..............s/ Peri S"-L� ti
. �...�.�;-_..__. .... , .
Tract . ...t- r--`' :��•,
' r.•..-..�w---`••.•cap+•^ +—+
Date Connected ��o^" .�/..� ..
.. y,_,.,K .'sL,y,,,r. :,ra f'(^a' t :y..ti. .• ,
. / '^�.:en4�+...iti, ••Cty, "?=.e �('r "'7,x,1
Date Final .. ... .... ._._. ! ... 'D, ._19�G .•`""�,-.<.�'
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LUMBINC INSPPCTOR
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