1364 (2) �oRS i I 1� P.ov� O1Rs52 I�WIL\Y OT NO.
No. STR
11110
N FOR PLUMBING PERMIT
OF CUPERTINO
EC 21 1961 i r
Date - 195_ Permit No. f � b
00
r 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 othe s ap icable thereto.
Use o Premises W
j ..4
v
Owne _' Address
;7� �By i s Address\y / '` a Ii 1-
CONTRACTOR, AGENT —/ !'' P-72.4 ]sI
Phone t Approved
PLUMBING INSPECTOR
FIXTURES NUMBER MAIN DRAINX��Y 1
I_UNITS I FEES UNITS FEES
Water Heater
I . ' I Size
Water Closets I Material (.
Bath Tubs. e To Curb- •fir Z., I I
Showers '"'^•. �_ �� To Prop. Line„ . " I•
Lavatories - . �� To Existing r1,
Kitchen Sinks ,j Not Conn.
Washers _ f - �� i- • !
tkjakte Disposals �� !
Wash'ys STORM DRAINAGE
Washing Machines �. �I Size
Water Softeners Material
Bar Sinks ',� �� In Main Drain
Comb. Sink--Trays To Curb �_?�• ' �i
Dc�hal Units
Drinking Fountains t.
Floor Dsins WATER SYSTEM`�� f
Hopper ' t 11 'Size .. 1
estaurant Sinks' ,�� Materialf5- .�
Sand Traps ?i TOTAL FEES
Urinals �. , •_ �� Fixture Fee
Area Drains .j _ 11 Main Drain Fee
Water Leaders - ;IStorm Drain Fee !;
Sp [ der aw• I
TOTAL � . TOTAL FEE
E�ORD OF INSPECTION �?
Partial Rough `�
Rough Complete • .� '•�
Final "x.