689 (2) w`^v LOT NO. 6
NO.. STREET r'
® ION FOR PLUMBING PERMIT
OF CUPERTINO /
Date 'I'MAR 95_ Permit No. Cc1 I
CITY �} TbFee $ f
Appllcatio he t 1Qp��City of Cupertino for a permit to install plumbing
�p 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
Cupertino, and all other la applicable thereto.
Use of Premise
:a
OwnerGC�SS�I/!l Address
ByQ P� TO Address Sl0
CONTRAC , AGENT _
Phone �� 3 — d�/j Approved
PLUMBING INSPECTOR /
TURES NUMBL•R MAIN DRAIN
UNITS FEES i1 I/ UNITSI FEES
Water Hrater I I II Size Zt
Water Closets 12 Material 2"
Bath Tubs To Curb
Showers+' �. To Prop. Lin
Lavatories To Existing
Kitchen Sinks a�T3t Conn.l�/�
Dish Washers II SEWER BOXES Ir/
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Machines / Size
Water Softeners Material j
Bar Sinks To Main Drain
Comb. Sink a Trays To Curb —w —
Dental Units
Dnnkmg.Fountainsl IIl
Floor Drains WATER SYST�I
Hoppers � � � Size T' �
Restaurant in Material p .I,
Sand Traps TOTAL FEES
Urinals Fixture Fee I ,p Q
Area Drains II Main Drain Fee I
Water Leaders _� I Storm Drain Fee I
Sprinkler Valves Water Sys. Fee Ij Op
Permit Fee 00
TOTAL I TOTAL FEE
RECORD OF INSPECTION '
.Partial Rough . GGQ ` _ •6
Rough.ti,omte
Final
I
Cunernl Sanitary
Micc Copy' 1
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO (�
Sewer Connection Sanitary Permit No. ..... /
,/,y/. .. .
Plumbing Final Plumbing Permit No- -----0-9............
/� . ... Lot No. .... �7'..............
Owner or Tenant'_.(�.._.� . ....^.�-.�.�1._.-.�. .� Q. ,i(�C,! ..
At ....../. -gid -.�,� ' �........._......... ------
Tract .......... ..fi �Fe%:..................................-------- ,._n: i
Date Connected ....._...._....._..... ------------
--- 19o:-
Date Final .............................� �...j. ..........
75- ........
Pi.L M13INC INSPPCTOR
111 7/59-5011