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'APPLIC 10FOR PLUMBING PERMIT
' CI ��, OF;CUPERTINO.
vSSS
Date r 19�0 Permit No.
UN 231860
Fee;$ '
'?
Application is hereb 'made to the City of Cupertino for a permit t install plumbing i
pipoWONAueeAKNNOreverse 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 other-la s'applicable thereto. Y i
u Use of Premises "' {
i i-d •g."
�
Owner=
f-i ..� `:Address
By J/� / Addiess`.;t$a:-
I CON ACTOR, AGENT/'
Phone — - Approved I -
P UMBING INSPECTOR
II
D
;FIXTURES ,NUMBER MAIN DRAIN
UNITS FEES UNITS� FEES
Water Heater Sae y
Water Closets Material
Bath Tubs / To Curb
Shower„ / To Prop. Line
Lavatories II To Existing �I
Kitchen Sinks N tcconn
Dish Washers 11 SEWER B%I-E
Waste Disposals
Wash Trays �_ �. �� STORM DRAINAGE
WasVach'ines �I Size
Wat ��- Material
Bar II To Main DrainComTo CurbDent
Dunking Fountains II
i
Floor Drains II WATER SYSTEM
Hoppers
Size ! f
Restaurant Sinks Material
Sand Traps TOTAL FEES
Urinals Fixture Fee lyrn0
Area _Drains Main Draih,Fee /,-00
Water Leaders I1 Storm Drain Fee I
Sprinkler Vaivcs II Water Sys. Fee /, 00
11 Permit Fee I.-ion
.TOTAL 11 TOTAL FEE /__:2 00
RECORD OF INSPECTION
Partial•Rough
Rough Comp
let —
Final " / —
iia„' .
,� ,ay,• y - C 9a tino Sinitary�� '•
PT I..> b ..► 3� i nfl,+C COPY
� #.. BUIL®IR `INSPEcTO e A OFFICE
` cITY orcurF INT .
�E]
Sewer ConnectionSanitary Permit No Y-:........
�Plumbin Final - s�yynn .
g 'i � Plumbing Permit No. ......QG7! �?. .:.......
Lot No. ....
a
Owner or Tenant ..:. :. .....--.
/. . . .. .... . . ... .................. ..... ......
Tract ......_---. ..f • ....... .. .... . - - ---------...�............_........
......................................................... 19-44 .
Date Final .........:.......... .........
� /�.' .......................----------... .........---..........19...60
Date Connected
.......... .. ------.............. ..................
111 7/59-500 CA,UMBING INSPECTOR
I