1107 (2) X09}Q Pt°PPrR r19FAr LAN L'— LOT NO.
NO.• ET
�LefC PLUMBING PERMIT
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QAPR'
A 7 1901 I P CUPERTINO
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Date 195_ Permit No..,l• o
CITY OF CUPERTINO,*tic Fee $ r
Application is hereby made to the-City of Cupertino for a permit toinstall 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
V Cupertino, and all other-laws applicable thereto.
.8 Use of:Premises- !LJ•E S/L�L`NG L%
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y ^OwnerLOnutteuwrAtr/r 'RLORC. i Addre36`T.. -
,� Y By P060 /COMAv L�ccc'''��* Addr s/
A .CONTRACTOR, AGENT ry j
Phone• -L'iP—k'— tt / j\ ApAed`
tai PLUMBING NSP CTOR
i
CIXTURES NUMBER MAIN DRAIN"
UNITS FEES IUNITS1 FEES
Water Heater "' Size
Watei Closets I g �� Material I ''/- I
Bath Tubs 1 11 To Curb I i'
Shower's ,7. To Prop. Line I✓-
Lavato%:ies 3 To Existing
Kitchen Sinks Not Con
Dish Washers
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Machines Size �I': I
Water Softeners - 1� Material IIS' I
Bar Sinks I "' 11 To Main Drain _
Comb. Sink & Traysl 1 II To Curb I' ,
Dental Units s I I
Dunking Fountains)
t
Floor Drains WATER SYSTEiv f
Hoppers Size Imo_
Restaurant Sinks II Material
Sand Traps TOTAL FEES '
Urinals Fixture Fee I O•0.0
Area Drains r Main Drain Fee jAj,as
Water Leaders _ Storm Drain Fee
Sprinkler Varves Ware[ $y5. Fee
SEINER BOXES Permit Fee jl%to u
TOTAL - _ .TOTAL FEE /p. vo
R W01Partial Rough Rough�omplet Finali �'
NOTICE OF ADDITIONAL CHARGE
CITY OF CUPERTINO'
}' '11. ING INSPECTOR'S OFFICE:
Date _, -D '. .c lrJ'-"�/. Permit No. .. .l..l..d.../...._.......---. .
To .... .. . . ... .-� -- ._------......-.._..._....-.
Address
..... . ..... .. .•--
CITY CUP T --
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Reason ......"'.... .....�..1 .-.
.. ....-.-.
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................................:: -' .i""'.--.._..-..:._-.._ '•i-
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106
_w ids n
Ih Amount S . Y_..`......... ;,;I Signed ..-_(.. _-`_._-._ --..._.--... ....... -. -----
_..
_ Cupertincb-Sanitary
.1.. -
Office Copy.
'BUILDING'riNSPECTOR'S OFFICE
M1 C'ITY',OP`CUPERTINO'.
SeNver Connection G ry
El _ � -52mtary :Permit No. . J 6 0- .
[j!Plumbing,Final Plumbing Permit No.
r Ot
Owner or Tenant .. ... .... ... .......... .................
L LSA '1
At /
Tract ,Connected c. � _ ---
-----------------------
Date.
/
.. Date Connected +>, '�•a� /
Date Final ----'.................._ i`;=: r /.� 6✓;'L
... -
.. .. . u
lit 1/60.500 ` �'' .
MINGA
INSPI C I OR