1145 (2) a D 9y/ I 1VF//"F/1 710cF _ LOT
NO. STREEV •
^' OR PLUMBING PERMIT r<_,
IF CUPERTINO '
UN 16=10
'`- Date 195_ Permit No._ �� A
CITY OF CUPERTINO Fees �4 —
Application is hereby made to the City of Cupertino for a permit to install plumbing
:.pipes and/or f2iturev listed on'the'reverse side hereof, and agrees to install said prices
add/or fiiitures.in accordance with the provisions of the Plumbing,Code of the City of
Cuperfiiiorand''a"'other laws applicable thereto.
Use,of>Premise's`
-, }a3 ..
4BU wdiwr�t�t/' BlD/lt Address
AddressApproved PLOMBIN INSPECTOR /�
— FX URES- NUMBER - MAIN DR IN
I UNITS I FEES II/ UNITS FEES
Water Heater . 1. It Size
Water Cb:sets 3 _ • , ,. ��"Material C/
Bath Tubi` ' / - To Curb
Showeri-; - ,�� 2 .. � �� To Prop. L'iner,[_._
Lavatories '�, 3 -=J .�� To, Existing,
Kitchen Sinks ~' / �. �� N C nn
Dish -Washers
Waste.Disposals / �� 3 -
Wash 'frays STORM DRAINAGE
W 'hing:'Machines /, ; „ 1Ya ,I Sizc r -
„WSofteners' ' : " r; i� Material z. I
Bar Sinks----',,, ��.:.f .,�' , • �� To Main Drain, :i'
Comb.'Sink a Tiays�":, ( '� �� To Curb
Dental Units
I Drinking,g,Fountaios�._•._,i
Floor Drains-, !;R �,: , �� WATER SYSTEM
Hoppers 17'`�iY1 .. `�` I �� Size r
Restaurant Sinksjj, Material
Sand Traps I'i ='j 1,_? 11 ? TOTAL FEES
Urinals `;.. ,�i Std ..{ -117 Fixture Fee
I Area Drams',' : •'� ';':-, 't�7�> '_) 1�,,Maih Drain Fee
Water Leaders : ,-.; 11 _Storm Drain Fee
Sprinkler Valccs:- ^',Water Sys. Fee /,OU
Q7t7ES=,a ; 11• Y2,9 •��'2mit Fee /•o 0
TOTAL"' i;+' .14 .2y,jji.-TQTAL FEE jVt a t
COR '•OF i TION
Partial Rough+. .• �'
Rr�h Complete ' � `
Final Z•' i f '_�+M
' r
7 1Cupertino Sanitary
:icc Copy
BUILDING .INSPECTO S0 FICE �� '
0, ->
C[TY OP CUPERT O,_�
Sed'er, Connection' 1 Sanitary Permit No '-- .- =`+
e'. Plumbing,Final _ ;, .• . Plumbing Permit No.' ..//-�..:........ _
Lot.No *---.-4' .........A +. =
4-Owner or Tenant - ---------
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Tract
•" Date Connected -----------------------------------N ��..-...._......-_.... .-:...- ---- .. 14-4-.
Dnte Final ...... ---
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JO
PLUMBING INSPECTOR - '-