1390 (2) &PPrA 'T/1e rA- L 4 AI Z63 LOT No.
NO. ..,. '.
PJANPLI PLUMBING PERMIT
2 519 'CUPERTINO
L -Dat e A/ri B Y .✓'. <— 19�5� Permit-No.
PERTINOSo. y
M
Fee $ t
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
tl� Cupertino, and all other laws applicable thereto.
Use of Premises 1 t<l& ly C tr
:a
v
Owner rrl "M0A,,vrA4ry .Atud_nr,o a Address If at X0<r,.
vRO V P/.vM G 11V
By� _ Address
i� CONTRACTOR, AGENT
i4 Phone c�-G !r !Y I Approved
�+±• / PLUMBING INSPE OR
FIXTURES NUMBER . ';MAIN, RAIN ,4
I UNITS I FEES II: 1 :11 'J3 7 IUNITS I FEES
Water Heater III Size' i1 yllaj it j✓
Water Closets '11 _Material ::G I j( f.,/ I
Bath Tubs I _, !�� To,Curb J,�
Showers I I To',Prop, 'Line,r .
Lavatories 11 To;Existing,
Kitchen Sinks 11' No n 'Z
Dish Washers
Waste Disposals
Wash Trays �, "STOW DRAINAGE
Washing Machines 11 ,) l l,'.Siie;
Water Softeners
Bar Sinks 11 To!Maiii Drain, 1..- l
Comb. Sink s-Traysl i l II To :Ctirb"I
Dental Units I }c;V,,j S
Drinking Fountains) 11 ' to li }
r
MoC Drains - 11 WATER'SYSTEM,I _
' r I I ll :Size.,;4=1171.�iil" �✓ L
Restaurant Sinks . I . 1 . Alaterialt��Ca;•) . }✓.
Sand Traps nTOTAL*FEES
Urinals - I IL Fixture'�Fee: 0
Area Drains l , 11 Main Draio{Feel•l' " f, J U
Water Leaders ' ,III Storm Draiffee I-
Sprinkler Valves Water Sys!(Fee - l
&EWFp en..E6 f I .2ti oll Permit,Feet
TOTAL I ',l" TOTAL3 FEE /1,CO
C RD OF`� 1 CTION
Partial Rough ,yj
Rou✓♦ Compl � 3 '.