1143 (2) 1?099/. PEPPER 7/PEE LOT NO _3
.
- NO, STREET - .
FOR PLUMBING PERMIT"
/JUN '
OF CUPERTINO
•
Date 195_ -Permit-No.
CITY OF CUPERTINO� Fee
;;• _� ,Application is hereby-made`tothe City of Cupertino for a permit to i stall plumbing -
4i..%= pipes and/or,fixtures listed on,the reverse side hereof, and agrees to install said'
prices
'
� and/or`fi>;tures in accordance with the provisions of the,Plumbing,Code of the'SCity1 of
V Cupertino, and all other laws applicable thereto.
8 Use of Premises 4-S'lDE N GN'
I
...�
,Owner /enrmeivweAATN ,0.t0.PS Address o
14 _ By URD Y M Address I LG
CONTRACTOR, AGENT
.� QQ - Approve,
`
hone fR-��k///
- PLUMBING IN9PECT0q.
FIXTURES NUMBER MAIN DRAIN
_ UNITS I FEES JUNITSI FEES
I Water Heater Size
Water Closets I 3 ;'�_ �, Material .`Ic/! I
Bath Tubs. / To Curb
Showers �+ � I To-Prop. Line;t 7>i/
Lavatories 3 - To Existing •; . '
Kitchen_Sinks / �. No Coaqy
Dish Washers,
Waste Disposals.
Wash Trays _ { STORM DRAINAGE
Washing Machines / I� Size
Water Softeners 11 Material
Bar Sinks To Main Drain
Comb:Sink &.-Trays �- ' To Curb ,. -• r
Dental Units
Drinking Fountains) I Ii
Floor Drains II WATER.SYSTEM
Hoppers - 11 Size' i i_ , :'I I_
Restaurant Sinks 11 Material zvt I4JA✓.1
Sand Traps {TQTAL: FEES
Urinals -Fisture{Fee.{F"Fp: /"rL•2 S
Area Drains �, Main Drainf.Fee 1 0 e,
Water Leaders jI _Storm DrainFee I _
Sprinkler Vawes �I- Water j1$y5. {Fee
r—WFA M)XZS I -a j Permit Fee {; /. 0 u
TOTAL, I TOTAL FEE, ! /Y,at
R CO D OF'INS CTION f '-
P rtial Rcugh
,. ugh Complete
Final 2
Cupertino Sanitary
Office Copy
BUILDING -INSPECTOR'S OFFICE '
.:CITY:OF CUPERTINO ? '
.❑ Sewer-Connection, - ;,Sanitary, Permit No. ....`.
- r -'--/-- ------
,.B"�Plumbing Final Plumbin ,.Permit'No.••"•�' ........ ...........
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- ::r.i:?;.^ - - - • Lot No
Owner or Tenant - . /nJ�'YJ2 ?'�-C�t�4�/-{��Qj�r� jJ�p_
gar
Tract _ .- y
�y
I{I{�Date Co enn e�--»-Yv-` ra'"' ��2 y`�;` 'w—. .•_`'��'�- ' 19/� �F•
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Date Final!-: / ,r
• �.. • ..
*0
,_•I.. J-... 8 EYP •� 1^Jvfr
�• ($( � - �•' /�?LUn1llINC INSPCCf OR
•r,�' 6 1 I l 1/60-500 0 J/'
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